Understanding the Long-Term Care Needs of the Medicare Population and the Role of Long-Term Care Pharmacies in Addressing this Need
As many as 70 percent of individuals who reach age 65 will experience severe long-term care (LTC) needs before they die. These needs include assistance with everyday activities such as bathing, dressing, managing medications, and managing finances. LTC pharmacies play a crucial role in supporting this population by offering medication management, care coordination, 24/7 support and emergency medication delivery, and caregiver and patient education. However, state and federal policy and health plan requirements can create barriers that restrict people aging outside facility settings from accessing long-term services and supports, including LTC pharmacy.
In partnership with the Senior Care Pharmacy Coalition (SCPC), ATI Advisory analyzed the 2018 Medicare Current Beneficiary Survey (MCBS) to create a profile of Medicare beneficiaries with LTC needs. The analysis found that Medicare beneficiaries with LTC needs are more likely to be Black or Latinx, female, dually eligible for Medicaid, clinically complex, and have higher healthcare and prescription drug utilization than beneficiaries without LTC needs.
Individuals with LTC needs are living both in facilities and in the community, so LTC pharmacy services should not be limited to those who reside in facility and institutional settings. Parity in LTC pharmacy coverage across facility, home, and other community settings can help improve equity and outcomes for individuals with LTC needs and provide necessary supports to their caregivers.