Why Life Plan at Home Programs Need Actuaries

Members | December 03, 2018 | by Stephen Maag

A 4-hour Deep Dive during the 2018 LeadingAge Annual Meeting highlighted the important role that actuaries play in establishing and sustaining Life Plan at Home programs.

Well over 200 members attended the Life Plan at Home Deep Dive during the 2018 LeadingAge Annual Meeting & EXPO in Philadelphia. Attendance at the session, which took place early in the morning of Sunday, Oct. 28, illustrates the significant and growing interest in Life Plan at Home among LeadingAge members.

The Deep Dive began with a presentation on the important roles that actuaries play in helping organizations establish and sustain Life Plan at Home programs.

AV Powell from AV Powell & Associates, and Brad Paulis from Continuing Care Actuaries, highlighted the role of actuaries in developing and operating Life Plan at Home programs. Both presenters are actuaries with extensive experience with these programs.

The Role of Actuaries in New Programs

Actuarial analysis is a critical step in developing a new Life Plan at Home program. In his presentation, Powell described how an actuary can help a new organization:

  • Define what benefits the program may offer;
  • Establish a fee structure that will provide sufficient resources to meet the cost of the benefits offered;
  • Model the impact of limitations, such as daily or lifetime caps, or exclusion periods;
  • Budget for administrative and marketing costs; and
  • Establish cash-flow benchmarks.

The Role of Actuaries in Maturing Programs

Paulis discussed how an established Life Plan at Home program still needs actuarial review as it matures. This way, assumptions made at the start of a program can be updated based on actual experiences.

Actuarial review is also necessary as Life Plan at Home programs consider ways to modify their benefits to meet changing consumer demands. An actuarial review can also play an important role in determining how customers with long-term care insurance are treated in a Life Plan at Home program.

Other Segments of the Deep Dive

The Deep Dive session also included presentations on other aspects of Life Plan at Home programs:

  • Craig Kinsey and Amy Nicklas explained how Cadbury at Home’s program has evolved over the years.
  • Lisa Formica of FMI Marketing Solutions highlighted the importance of a sophisticated direct-marketing plan.
  • Lynne Giacobbe from Kendal at Home discussed the importance of care coordination and utilization, and how her organization has developed effective tools and measures to manage this critical component of a successful Life Plan at Home program.
  • Joan Kruger and Joe Wenger from Longwood at Home, Jennifer Egizi from Willow Valley, and Jonathon Cook from Lifespire Living discussed several operational issues and responded to questions from the audience.