Trends in Aging and Long-Term Care August 17, 2007.
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Transcript of Trends in Aging and Long-Term Care August 17, 2007.
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Trends in Aging and Long-Term Care
August 17, 2007
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LTC Expenditures Florida
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Trends in Aging & Long-Term Care
1. Number of aged will continue to grow
2. Increases in retirement age and favorable dependency ratios
3. Favorable long-term care nursing home utilization trends expected to carry for another 25 years
• Improved health and lower disability rates
• Lower rates of widowhood
• Growth of Assisted Living Facility (ALF) and Continuing Care Retirement Community (CCRC) industries
• Well developed network of home care providers
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4. Nursing home reimbursement rates growing five percent over inflation
5. Shortages of health care professionals and paraprofessionals
Trends in Aging & Long-Term Care
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Growth in Aging
Growth in Retirees and Oldest OldFlorida
01,000,000
2,000,0003,000,000
4,000,0005,000,000
6,000,0007,000,000
1970 1990 2004 2010 2020 2030
Year
Persons 85 and Older Persons at Retirement Age
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Growth in Aging
1.0
1.2
1.4
1.6
1.8
2.0
2.2
2.4
2.6
2.8
3.0
1990 1995 2000 2005 2010 2015 2020
Re
lati
ve
Gro
wth
60-84
85+
0-59
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Share of Elder PopulationFlorida
0%
5%
10%
15%
20%
25%
30%
1970 1990 2004 2010 2020 2030
Year
85+ Share
Ret.Age Share
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Dependency RatiosFlorida
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1970 1990 2004 2010 2020 2030
Year
Dep
end
ents
per
wo
rkin
g
age
adu
lt
Retirees Children <20
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Disability Rates1. Since 1984 disability rates have been
declining at about one percent per year.
2. This trend is expected to continue. Between 2000 and 2050 the rate of severe disability among the elderly is projected to be cut by half.
3. Older Floridians are 45 percent less likely to require long-term nursing home care than elders from other states.
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Source: AARP Public Policy Institute based on 1994 National Long Term Care Survey and U.S. Census Bureau population projection middle series.
Disability Rates (cont.)
6.4
7.07.1 7.0
7.1
6.4
7.5
8.3
9.3
9.8
6
6.5
7
7.5
8
8.5
9
9.5
10
1982 1989 1994 1999 2006
Actual Older Personswith Disability
Projected at 1984Disability Prevalence
Number of Americans 65 and Older with Any Chronic Disability(1982-2006)
Mill
ion
s
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Shift to Assisted Living Facility (ALF) Care
18,543
75,671
77,928
76,10874,723
72,96070,624
68,84267,189
64,706
80,24381,21881,30579,550
39,473
44,181
51,064
56,918
66,29567,439
70,590
74,767
80,998
76,514
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Nursing Home Beds
ALF Beds
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Stable marriage rates and declining disability imply that growth in the elderly population can actually lower demand for nursing home care because:
•As the elderly male population grows more rapidly than the population of elder females, the availability of spousal care rises.
• The supply of healthy caregivers rises.
Informal Care Trends
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Informal Long-Term Care
Publically Funded Long-Term Care14.5%
Non-Publically ProvidedLong-Term Care85.5%
Florida Long-Term Care Resources
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Nursing Home Use Growth Florida
10.18%
7.58%
3.00%
2.15%
1.44%
0.54%
1.04%
3.34%
2.12%
1.32%
1.63%
0.25%
-0.55%
0.07%
-0.75%
-2.02%
-4.00%
-2.00%
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
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Trends in Demand Nursing Home Care
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LTC Demand Factors (U.S.=100)
70 75 80 85 90 95 100
65+ Self Care orMobility Disability
65+ Self CareDisability
65+ Live Alone
Medicaid 65+
Summary Demand Factors
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FL O R U S
A ll Lon g-Term Ca reExpenditures Per 65+
N ursing H om e Expenditures Per 65+
FL O R U S
Percen t of 65+ Popu la tionin N ursing Fa cilities
FL O R U S
Florida’s Long-Term Care Costs Are Lower Than Other States
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$99.87
$112.98
$137.58
$149.61
$150.10
$127.92
$107.31
$95.18
$90.00
$100.00
$110.00
$120.00
$130.00
$140.00
$150.00
$160.00
1997 1998 1999 2000 2001 2002 2003 2004
Growth Rate 6.7 Percent Yearly
Negative Trend:Nursing Home Per Diem Growth
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1.00
1.25
1.50
1.75
2.00
2.25
1991 1993 1995 1997 1999 2001
Re
lative
Gro
wth
Medicaid Bed Utilization
Nursing Home Budget Growth
Costs: Nursing Home Budgets Growth
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Trends in Nursing Home Costs
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Policies to Control the Growth in the Public Cost of Long-Term Care
Support and encourage family and personal responsibility Education Support and foster development of
affordable long-term care options Aging Resource Centers as local contact
for education, information and referral
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Policies to Control the Growth in the Public Cost of Long-Term Care (cont.)
Support health promotion and wellness Social Intellectual Physical
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Policies to Control the Growth in the Public Cost of Long-Term Care (Cont.)Support a public long term care system that Favors community based care
Promotes deinstitutionalization Removes any institutional bias
Is customer centric Has flexibility
Funding follows the consumer across care settings Service dollars can be used to supplement rather than
substitute for personal/family resources Services can be used on a preventive basis
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Support a public long-term care system that Prioritizes and targets services based on risk Maximizes return on investment
Integration/maximization of federal funding streams
Integration of care Risk transfers/sharing Administrative efficiencies
Policies to Control the Growth in the Public Cost of Long-Term Care (Cont.)
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Comments & Suggestions
Horacio Soberon-Ferrer, Ph.D.
Florida Department of Elder Affairs
850-414-2089
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Comparison of Annual Cost Per Customer of Programs Serving Florida's Elders State Fiscal Year 2005 - 2006
$1,891
$2,329
$4,680
$7,933
$8,323
$8,740
$21,063
$44,836
$0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000
Older Americans Act
Home Carefor the Elderly
Community Carefor the Elderly
Medicaid Aged/Disabled Waiver
Alzheimer's DiseaseInitiative
Medicaid Assisted Livingfor the Elderly Waiver
Medicaid Nursing Home Diversion Program
Nursing Home
Incr
easi
ng
Fra
ilty
Annual Cost Per Person