Transcript of "Beyond the nursing home (2012 ICA)"
Long Term Care:Beyond the Nursing HomeInternational Claim Association2012 Annual Education ConferenceOrlando, FLOctober 2, 20121
Robert R. Pohls, Esq.Pohls & AssociatesWalnut Creek, CaliforniaPeter K. BurkeAVP, LTC Claims OperationsJohn Hancock Financial ServicesBoston, MassachusettsRita Bennett, RN, BSN, LTCPDirector, LTC OperationsBankers Life and CasualtyChicago, IllinoisLori M. WatsonDirector, LTC ClaimsGenworth LifeSan Rafael, California2
Session Agenda• Goal of session• Interactive session – audience participation!• Long Term Care• Past• Present• Future• Wrap up3
The Early Years:1970’s – Early 1980’sA Walk Down Memory Lane…LTC Options• Nursing Homes• Slow emergence of Assisted Living Facilities• Concept of “graduated care” emerges4
LTC Insurance• Traditional health insurance generally did not cover LTCoptions• LTC offered by only a few companies• Medical Necessity trigger determined by admittingphysician• Indemnity-based benefit structure• Prior hospital stay requirementThe Early Years:1970’s – Early 1980’sA Walk Down Memory Lane…5
The Early Years:1980’s – Early 1990’sA Walk Down Memory Lane…LTC Options• Nursing Homes• Assisted Living Facilities• CCRCs/Life Care Communities• Home Health Care, Adult Day Care, etc6
LTC Insurance• Comprehensive policies• HIPAA impact and NAIC influence– Chronically Ill trigger– Qualified Long Term Care Services defined– Non-duplication of CoverageThe Early Years:1980’s – Early 1990’sA Walk Down Memory Lane…7
The Early Years:Mid 1990’s – PresentA Walk Down Memory Lane…LTC Options• Nursing Homes• Assisted Living Facilities• CCRCs/Life Care Communities• Home Health Care• Adult Day Care• Supportive Equipment8
LTC Insurance• Comprehensive policies• More insurers enter the market• Expense reimbursement benefit• Popular and sought out coverage• Growing media, Departments of Insurance and consumerinterestThe Early Years:Mid 1990’s – PresentA Walk Down Memory Lane…9
Lessons Learnedand the Future of LTC• Lessons learned?• Gaps - what are they and how do we address them?• Alternate Plans of Care – what are they being used for?• Long term care delivery – what are the expectations?A Few Thought Provoking Questions…10
Wrap up – Questions?!?!Robert R. PohlsManaging AttorneyPohls & Associates1550 Parkside DriveSuite 260Walnut Creek, CA 94596Ph: (925) firstname.lastname@example.orgPeter K. BurkeAssistant Vice PresidentLTC Claims OperationsJohn Hancock Financial Services200 Berkeley Street, B5Boston, MA 02117Ph: (617) email@example.comRita Bennett, BSN, RN, LTCPDirector, LTC Consumer Relations,Risk ManagementBanker’s Life111 E. Wacker DriveChicago, IL 60654Ph: (312) firstname.lastname@example.orgLori M. Watson, CLTC, LTCPDirector, LTC ClaimsGenworth Life1650 Los Gamos DriveSan Rafael, CA 94903Ph: (415) email@example.com
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