Comptroller Releases Report on Senior Long-Term Care in Tennessee

The Comptroller’s Office of Research and Education Accountability (OREA) has released a report examining the projected growth in Tennessee’s senior population (age 65+) by 2030 and its impact on public long-term services and support programs for low-income Tennessee seniors.

The report is intended to provide objective analysis and options for policymakers’ consideration. The report does not make recommendations.

The number of Tennessee seniors age 65 and over is expected to almost double from 850,000 in 2010 to 1.7 million in 2030. Although Tennessee has made changes in its TennCare/Medicaid program to help control the growth in the costs of long-term services and supports, costs will likely increase substantially in response to the expected growth in the senior population by 2030.

The report focuses on Tennessee’s three primary publicly funded long-term services and support programs for low-income elderly Tennesseans: TennCare CHOICES (Medicaid), Options, and Older Americans Act (OAA) programs. Together, these programs provide a continuum of services ranging from information and referral, meals, varying levels of home and community based services, and nursing home care.

Research indicates that greater use of home and community-based services, where medically and safely appropriate, meets older adults’ preferences to age in place, and can reduce the lifetime costs of long-term care by delaying seniors need for more expensive nursing home care.

Enrollment of TennCare-eligible seniors in home and community based services has increased from 11 percent in 2009 to 35 percent in 2016, and TennCare officials expect this percentage will grow in future years.

Other Tennessee public programs and services available are designed to prevent or delay seniors in enrolling in higher cost TennCare CHOICES services, but they either have waiting lists for services, do not serve all seniors who could benefit from the services, or are serving fewer seniors in recent years. The report includes estimates of potential costs savings of providing more seniors basic home services, such as meals, bathing, and light housekeeping and delaying nursing home care.

Policy options described in the report for policymakers’ consideration include:

– Further expanding home and community based services for seniors including improved transportation, support for caregivers, and expansion of the continuum of community care facilities.

– Developing and investing in direct senior-care workers.

– Further developing a comprehensive and coordinated system of aging services.

The report is available on the Comptroller’s website at http://www.comptroller.tn.gov/OREA/