With survey data indicating a preference by elderly people for staying out of nursing homes, a coalition of business groups and policymakers wants Connecticut to better support such home-based systems, arguing the state could ultimately save $900 million annually on long-term care costs.
The findings were released by the Connecticut Regional Institute for the 21st Century, whose steering committee includes representatives from the Rell administration as well as from the Connecticut Business & Industry Association, Stamford-based Pitney Bowes Inc., the Business Council of Fairfield County and the Bridgeport Regional Business Council, among others.
The organizations also recommended the state”™s various agencies create a single, streamlined point-of-entry process for citizens applying for long-term care programs; find ways for private insurance programs to pick up more of the cost of long-term care; and ensure that home-based care is considered for patients being discharged from acute-care hospitals.
The study was put together by BlumShapiro, which culled data from 15 interviews with policymakers and a swath of existing reports, including a January filing with the state Legislature by the Connecticut Long Term Care Planning Committee. The study included the long-term care needs of adults with mental disabilities.
It was the first of multiple reports promised by the institute this year on programs that consume large portions of the state budget.
During the fiscal year ending last June, Medicaid spending in Connecticut totaled $2.5 billion with the state picking up half the tab. That accounted for more than half of all long-term care spending and 13 percent of total budget expenditures. The number of adults age 65 or older is expected to jump 40 percent, adding more than 200,000 residents to the Medicaid system.
In a separate study published last week, the Association for Long-Term Care Insurance noted an increase in the average age of first-time policy purchasers and a trend toward lower-cost benefit packages.
“Clearly the economy is having an impact on when individuals start their long-term care planning, and what benefit levels and policy options they select,” said Jesse Slome, executive director of the organization, in a prepared statement.
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In Connecticut and nationwide, Medicaid has made reimbursement for nursing homes and other institutional care easier than that for home and community-based care, which has resulted in residents being directed to expensive institutions rather than being cared for in their homes, a cheaper option in many cases.
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BlumShapiro found that just over half of residents receiving long-term care receive medical care in their homes who would traditionally have resulted in a stay at an institution like a nursing home. According to BlumShapiro, better reimbursement for home-based care could push that figure to 75 percent, saving the state $900 million annually by the year 2025.
That puts Connecticut below the national average and 34th among states, in terms of progress toward the “rebalancing” sought by the institute and its members.
On average, Connecticut”™s Medicaid dollars can support two elder citizens at home for every one in a nursing home.
One does not need to twist arms to get the elders on board ”“ nearly 80 percent expressed a preference for receiving care in their homes, according to a 2007 University of Connecticut Center on Aging survey.
“Our economic downturn has created both increased need for public services while sharply reducing state revenue,” said Jim Torgerson, CEO of the United Illuminating Co. and its New Haven-based parent UIL Corp., and chairman of the institute. “The numbers in Connecticut are of increasing concern and can seriously impact all levels of government in the state.”
Connecticut policymakers have already attempted to tackle the problem with the “Money Follows the Person” program, which has received funding from the U.S. Centers for Medicare and Medicaid Services. To date, the program has transitioned nearly 200 people from nursing homes to residences, and early program results have shown an average decline in monthly costs from an estimated $1,650 for institutional care to $960 for home and community-based care.
