Long-term care insurance (LTCI) carriers may be able to hold down claims costs using the same kinds of analytical and condition management programs that major medical insurers use.
John Criswell, the chief executive of Pulse8, talked about that idea recently during a presentation at a conference organized by LIMRA.
LIMRA has posted a copy of the LTCI data presentation on its website.
Criswell talked about many sources of data that show, for example, how an LTCI carrier might be able to distinguish applicants who are clearly bad LTCI risks from those with chronic conditions who might nevertheless be reasonably good LTCI risks.
Once an LTCI carrier has sold a policy, it could use similar techniques to identify policyholders who might benefit from help with controlling risk factors that could eventually lead to LTCI claims, Criswell said, according to a copy of his presentation.
Prevention programs could involve problems as high-profile as high blood pressure and as deceptively simple sounding as falling, Criswell said.
Although falling might sound like a small problem, “30 percent of people over 65 years of age fall each year,” Criswell said. “Ten percent of fallers have serious and expensive injuries that lead to LTC claims.”
An LTCI carrier may be able to reduce fall-related claims costs — and improve policyholders’ quality of life — by identifying policyholders ages 65 to 75 who have risk factors such as a history of falling within the past year, a fear of falling, heavy drinking, pain and stiffness in joints, three or more functional limitations, or dizziness Criswell said.
Strategies for reducing the risk that those policyholders will fall could include modifying their homes, getting them into group exercise or home-based exercise programs, or encouraging them to sign up for Tai Chi classes, Criswell said.