New Report on Reform Options for Long-Term Services and Supports (LTSS) in Minnesota Aims to Enhance Access and Explore New Funding Approaches for Older Adults

December 04, 2023

As the population of the United States ages, Minnesota and other states, have been looking for solutions to increase the accessibility and funding of long-term services and supports (LTSS). In partnership with Own your Future, a Minnesota DHS Adult and Aging Services initiative, Altarum, FTI Consulting, and Actuarial Research Corporation obtained recommendations to transform LTSS access and increase funding options.  These recommendations are outlined in the newly-released report “Options to Increase Access to Long-Term Care Financing, Services, and Supports in Minnesota.”

A core component of this study was stakeholder engagement and feedback. Through a series of discussion panels, stakeholders were given background on how older adults in Minnesota are currently having their LTSS needs addressed, and were asked to propose alternative solutions in response. Specific emphasis was made on the current state of LTSS support, highlighting that these supports are mainly available to households with an income level below $25,000 and above $125,000 annually. The remainder of the population became the primary focus for stakeholders, who referred to this middle-income group as the “red box”. Given this information, stakeholders developed recommendations that had the intention of reducing Medicaid costs, as well as increasing supports for older adults in Minnesota. 

Actuarial and financial modeling helped drive the stakeholders to make their final decisions on the recommendations. This included indicative pricing of the recommendations under consideration using, payroll tax and premium funding approaches, determinations of the likely coverage levels of participants, the likelihood of participants using potential benefits, and a projection of the value of potential LTSS needs of older adults in Minnesota.

The recommendations developed by stakeholders were as follows:

  1. Care Navigation & Support Services
    A state initiated and collaborative care navigation and support service for all older adults. The purpose is to leverage existing services, provide strong awareness and education, and support families and informal caregivers during their care journeys through a broad online and telephonic approach. 
  2. A Medicare Companion Product
    A new insurance product concept that coordinates and funds care needs emerging in retirement. The program would coordinate care across the acute and LTSS care needs through collaborative Medicare and LTSS supporting products. There are two approaches, a voluntary Market Option or an Obligatory Option.
  3. A Catastrophic-Lite State Based Program
    An obligatory state insurance program that would provide funds to help pay for long-lasting, long-term care expenses for five years after a two-year elimination period. The focus is on home and community-based services (HCBS) but funds would be available for facility care as well.

As Minnesota continues to look into ways to expand LTSS access, this report will provide them with a solid foundation on potential options and challenges. The study findings can also be adapted and customized to cater to the requirements of other states that are looking to address their own LTSS issues.

Read the Options to Increase Access to Long-Term Care Financing, Services, and Supports in Minnesota report.

Altarum works to improve health care services for older adults and people with disabilities by focusing on quality improvement, policy initiatives, and models of reform to ensure that high-quality care and supportive services are available for all who need them. Learn more about our initiatives to shift residential long-term care to a person-centered model and evaluate the PACE model of care.