New Data Show Parallels in Long-Term Care Needs between Patients Who Reside at Home and Those in Facilities

DATE: July 28, 2021

Research Reveals Substantial Unmet Health Care and LTC Needs for Those Living at Home; LTC Pharmacy Services Are Essential to the Aging Population Regardless of Residence

Washington, DC - As Congress debates access to important home and community-based services, new analysis of Medicare data from the Senior Care Pharmacy Coalition (SCPC) and ATI Advisory (ATI) shows that individuals with long-term care (LTC) needs have similar medical and pharmacy expenses and complexity regardless of whether they reside in the community or a facility setting.

Despite this close resemblance, current policy limits LTC pharmacy services to individuals living in facility settings (e.g., skilled nursing facilities and assisted living communities), leaving older people who choose to live at home with potentially unmet needs. SCPC/ATI research shows that nearly 75 percent of today’s Medicare beneficiaries with LTC needs live at home or in other community settings (e.g., independent living and retirement community), suggesting a gap in access to important services for these individuals and pointing to the need to clarify and expand current policy.

The U.S. Department of Health and Human Services predicts 70 percent of individuals who reach age 65 will need LTC services (defined as needing assistance with at least two activities of daily living, such as bathing oneself or eating) at some point in their older adult life. Additionally, this new analysis shines a light on the demographics of individuals with LTC needs living in the community revealing that Black and Hispanic/Latinx individuals are more likely to live in the community and are particularly impacted by disparities from LTC facility bias.

This analysis also finds that Medicare beneficiaries with LTC needs residing at home require more prescriptions, on average annually (14) than their counterparts in facility settings (12). This suggests that a successful infrastructure for aging-in-community should address access to a range of LTC services, including LTC pharmacy services, and integration of LTC services and health care services for individuals with LTC needs.   

“As we look to improve health care for older Americans, it is essential that individuals have access to all necessary services including LTC pharmacy services wherever they live and regardless of their personal resources,” said SCPC President and CEO Alan Rosenbloom. “While the future of health care and services for our graying population is challenging, there are common-sense policy solutions like expanding access to home and community-based services (HCBS) and assuring equal access to LTC pharmacy services. We have a responsibility to ensure that the personal decision to age-in-community does not leave millions of people without high-quality care and services.”

“We need to include LTC pharmacies in current policy discussions around shifting LTC to the home and community,” said Anne Tumlinson, CEO of ATI Advisory. “This is yet another source of the institutional bias that is rampant in LTC coverage policies in our country.”       

Congress must account for a population that requires a more intense level of care, service integration, and care management, regardless of where they live. LTC pharmacies must play an essential role in the health care delivery for people living at home or in the community.

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About Senior Care Pharmacy Coalition

The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies, representing 75% of the sector overall. Its members operate in all 50 states and serve 850,000 patients daily in skilled nursing and assisted living facilities across the country. Visit seniorcarepharmacies.org to learn more.

About ATI Advisory

ATI Advisory is an advisory services and research consulting firm focused on transforming the healthcare delivery and financing systems for frail, older adults. ATI Advisory applies quantitative and qualitive research methods to identify opportunities to improve Medicare, Medicaid, and long-term care, and it stands by research and data as the foundation of quality.

SCPC Media Contact:
Allison Parker-Lagoo
202-884-7338
allison.parkerlagoo@finnpartners.com

ATI Advisory Media Contact:
Robert Shalett
202-365-0273
Robert@atiadvisory.com