Care management in long-term care insurance: meeting the needs of policyholders?

Despite the increase in long-term care insurance (LTCI) sales, little attention has been given to the quality of services provided to policyholders receiving benefits. This article describes a qualitative analysis of care management (CM) services within LTCI. Key components of analysis included the assessment and care planning process, service coordination, monitoring of policyholder needs, discharge planning, and consumer knowledge and satisfaction. Extensive case record reviews, including longitudinal in-person and telephone interviews with policyholders, caregivers, and other stakeholders, were performed to gain insight into the CM process as experienced by LTCI policyholders under the California Partnership for Long-Term Care. Results suggest that CM may be somewhat restricted under LTCI. While the basic CM services available to policyholders may be appropriate for addressing the simple needs, individuals with chronic and unstable disabling conditions may require a more comprehensive form of CM.