Have you ever had one of those breakthroughs when it dawns on you that there’s an entire world going about its day just beyond your perception?
Idly daydreaming, perhaps your thoughts wander to the microscopic ecosystem which ekes out a living too small for the naked eye… or you remember that 3/4th of the Earth’s surface is covered in deep blue ocean, a larger world within our own of which we pay no attention.
So it is with LTSS and LTC, two worlds which co-exist practically in the same space and dimension…and yet their participants go about their daily lives oblivious to one another. To learn how this came to be, we must re-visit the past.
First came the nursing homes
This service modality cornered the market throughout the 1970s; therefore, marketers felt no pressure to either "frame" the term or substitute euphemisms. As the connotation of “nursing home” eroded throughout the 1980’s, "nursing facility" emerged as more palatable, until "assisted living" exploded from out of nowhere in the 1990s, unleashing a full-fledged thesaurus of new vocabulary.
By this point, agents couldn't give away "nursing facility" insurance for free, but found consumers willing to discuss “long-term care." What’s more, responses to the terms "assisted living" or "home care" went through the roof compared to other alternatives—agents and carriers learned caution in word choice. Potential prospects tended to picture themselves in certain care settings—if at all—and responded to ads accordingly.
Fast forward to today—even the words "long-term care (LTC) have acquired some of the rust and corrosion previously associated with "nursing home insurance."
Eager to shed hoary perceptions, the industry shuffles its options like a teenager trying on outfits: will "extended care" or "long-term healthcare" take over soon? Or will it be something else?
Which brings us to “long -term services and supports," or LTSS.
While LTC is the parlance of private industry, LTSS is the acronym of academia and government.
For nearly two decades, LTCI and long-term care insurance have been printed in millions of brochures, tri-folds and advertisements. Mandatory producer training and state regulations likewise ape the terms LTCI and long-term care insurance... but we step through the looking glass when it comes to institutional or economic research, think-tank analysis, international policy, or federal government legislation. In this wonderland, the terms are LTSS and long-term services and supports.
Although the private market has been aware of this alternate word, it’s been not only slow to react, but downright defiant.
This is because LTSS is the official language of the Patient Protection and Affordable Care Act (PPACA), enacted in March, 2010, where “Long-Term Services & Supports” is cited over 40 times. Worse, it’s the language of the infamous CLASS Act, the industry’s bête noir. Private LTC preferred to take no official stance regarding CLASS, but the Supreme Court upheld PPACA, and with it officially sanctioned the new vocabulary. The fact that LTC and LTSS live apart on land and water only shows how far apart the two sides remain.
As I’ve written in the past, the words we choose matter in the utmost. With so many dueling stakeholders, it will be fascinating to watch this particular vocabulary evolve.