Genworth’s CEO On The Future Of Long-Term Care Insurance, Government Catastrophic Coverage, And Going Private

Last month, Genworth, the biggest seller of long-term care insurance policies in the US, announced it was being acquired by a Chinese investor, China Oceanwide Holdings. I spoke with Genworth CEO Tom McInerney about the deal, the future of long-term care insurance, and the role of government in covering true catastrophic risk. Here is an edited version of our conversation.

Q: Why did you do the deal with China Oceanwide?

 Dementia Rates Are Falling In the US

An important new national study finds that, after adjusting for age, Americans 65 and older are less likely to get dementia than in the past. The report, published in the Journal of the American Medical Assn (JAMA) confirms previous regional studies in the US as well as recent research in Europe. The reasons for this decline in prevalence of the many dementia-related diseases are complicated, but may be related to higher educational levels. Whatever the cause, the news is positive.

How Trump May Remake Medicare

During his presidential campaign, Donald Trump was largely silent on Medicare, though he often suggested he’d leave the program untouched. Not any more. It now looks as if Trump may push for major changes in the principal health care program for older adults and some younger people with disabilities. But what will he do?

He has not said, but House Speaker Paul Ryan (R-WI) has been explicit about what he has in mind, and since the election Trump seems to have adopted much of Ryan’s language, suggesting he may also embrace his policy proposals. Those include redesigning the basic financial structure of the program and making Medicare Advantage managed care plans more attractive.

What The Trump Presidency Means for Seniors

The election of Donald Trump, along with continued Republican majorities in the House and Senate, will likely result in major cuts in federal programs that benefit older adults and younger people with disabilities.

Some of the programs that could be targeted: Medicaid, important reforms in the way health care is delivered through Medicare, and services funded through the Older Americans Act such as Meals on Wheels, adult day, information assistance. And while Trump vowed throughout his campaign to leave Social Security and Medicare untouched, congressional Republicans have targeted both programs and it is not clear whether the new president would resist their efforts to cut benefits.

How The Battle Against Opiods Could Put Some Older Adults At Risk

There is no doubt that the widespread over-use of opiods has become a serious public health problem in the US. But I worry that older adults with palliative care needs may become unintended casualties of efforts to reduce the use and accessibility of these powerful drugs.

The opiod problem is real. Nearly 30,000 Americans died from use of these drugs in 2014. Some were stolen or counterfeited, but many were prescribed by physicians who were lazy, incompetent, or corrupt. The opiod epidemic meme has even found its way into popular culture. The other day, John Oliver went on one of his famous 20-minute rants against the overuse of the drugs and who he thought was to blame (Big Pharma, in case you were wondering).

Long-Term Care Insurance Giant Genworth Takes Another Charge, Plans to Go Private

Genworth Financial, the largest seller of long-term care (LTC) insurance policies, has agreed to be acquired by a privately-held Chinese investment firm. At the same time, it announced it will reserve an additional $400 million to $450 million against future long-term care claims.

The twin Oct 23 announcements are further indication of just how brutal the long-term care insurance business has become. Struggling with larger-than-expected claims and continued low interest rates that have slashed investment earnings, scores of carriers have abandoned the market in recent years, and those that remained have sharply raised premiums on existing policies and tightened underwriting standards and raised prices on new ones. As a result, sales have plummeted. Sales of individual stand-alone policies plunged from a peak of about 750,000 in 2002 to only about 130,000 in 2014.

Long-Term Care Is Increasingly Becoming Managed Care At Home

Medicaid long-term care is rapidly changing, and some of those trends may eventually remake the way all of us receive personal assistance as we age or become disabled.

Nearly half of all states are now providing Medicaid long-term care benefits through managed care, and 13 states are requiring older adults to receive care that way. At the same time, four out of five states are expanding home care benefits through Medicaid and 16 are even beginning to provide housing services with their Medicaid dollars. These are just a few of the key findings in the Kaiser Family Foundation’s latest annual survey of state Medicaid programs.

Five Ways Family Caregivers Can Care For Themselves

I helped care for my dad, who was dying of heart disease, for about 18 months. I was not even his primary caregiver. My mother and a home health aide took care of most if his-day-to-day needs. Yet, after he died, I was exhausted–worn out like I had never been before.

Caring for an aging parent can be among the most rewarding things you do in your life. But it can also be physical and emotionally demanding. Family members caring for relatives are more likely to be hospitalized than people like them who are not caregivers. They are more likely to suffer from depression and physical injuries (from, for example, lifting a loved one).  Caregiving spouses over age 65 are even more likely to die prematurely than those who are not caregivers.

How One Man Helped Build A Better Medicaid Long-Term Care Program

My friend Dan Timmel died last week. You probably didn’t know him. But if you are a frail older adult or a younger person with disabilities who is a Medicaid recipient, a family member of someone on Medicaid, or a taxpayer, you owe Dan a great debt.

Dan was a senior career official on the Medicaid side of the Centers for Medicare and Medicaid Services (CMS), the federal office that oversees both programs. He had a simple vision: People who receive long-term supports and services from Medicaid should get the best and most appropriate care possible. And he worked relentlessly to make that happen.

What You Should Know About The Government’s New Nursing Home Rules

For the first time in 25 years the federal government has completed a comprehensive revision of the way it regulates nursing homes, where 1 million older adults and younger people with disabilities reside.

The new regulations—all 700 pages worth—govern everything from staffing and dispute resolution to enhancing the role of residents and families in designing care. They’ll take effect in stages over the next three years. And not surprisingly, both consumer groups and industry officials have already begun raising objections to some of the new rules.