New Report: Exploring LTSS Social Insurance Strategies in 6 States

Jul 29, 2020

Learning from New State Initiatives in Financing Long-Term Services and Supportsa 48-page report detailing findings from the analysis, was developed in partnership with Community Catalyst’s Center for Consumer Engagement in Health Innovation. A 12-page Executive Summary is also available.

The study was led by Marc Cohen, LTSS Center co-director; Ann Hwang, director of the Center for Consumer Engagement in Health Innovation; and Michael Miller, director of strategy policy at Community Catalyst.

The new report, written by Cohen and LTSS Center fellows Eileen Tell and Edward Miller, characterizes the status of emerging state-based social insurance programs. Using a qualitative, case-study approach, the researchers describe the nature and evolution of the LTSS finance reform(s) taking place in 6 states:

  • Washington.
  • Hawaii.
  • Maine.
  • California.
  • Michigan.
  • Minnesota.

Researchers conducted structured interviews with 42 key stakeholders in the study states. Their report:

  • Describes the policy change that was proposed or adopted in each of these states.
  • Identifies the common themes that emerged from key stakeholder interviews.
  • Draws out implications and lessons learned that may help inform policy development at both the state and federal level.

Medicaid is the largest public payer for LTSS, and roughly half that money is contributed by states. As an aging population increases demand for LTSS, pressure on the financial system will continue to mount.

“States feel the pain most acutely and this pressure has led a number of them to consider new ways to address the challenge,” said Cohen. “The overarching objective was to help state officials understand some of the different approaches that other states—which may be further along in their thinking and development—are taking in the area of LTSS financing.”

Read the full report.

Read the executive summary.