The Long-Term Care Imperative December 2011 Momentum Analysis Poll Results 1 The Long-Term Care Imperative
Purpose In order for the Long-Term Care Imperative to shift to messaging that will be successful in 2012, a baseline poll was conducted to test the public s view of Long-Term Care funding and which messages best resonate with the public. Goals of the poll included: Determine the most compelling and concise way to communicate the choices of care for consumers and what role of public funding should play. Test various messages for public positioning on issues related to aging Establish a baseline of public knowledge on key issues 2 The Long-Term Care Imperative
Methodology Momentum Analysis surveyed 600 respondents in Minnesota on November 13-15 th, 2011. Sample Universe: A random digit dial sample of registered voters and likely November 2012 General Election voters Also included were voters who intend to register on Election Day in 2012 The margin of error was +/- 4.0% 3 The Long-Term Care Imperative
Methodology Sample Characteristics Male: 47% Female: 53% HS or <: 17% Sm coll: 28% Coll+: 50% <40: 33% 40-59: 37% 60+: 27% Registered voter: 93% Plan to register before Election Day: 5% Plan to register on Election Day: 2% Women <50: 26% Women 50+: 26% Men <50: 25% Men 50+: 20% Minneapolis/St. Paul DMA: 79% Other DMA: 21% Hennepin: 22% Anoka/Dakota/Ramsey: 23% Other Counties In Minneapolis DMA: 34% 4 The Long-Term Care Imperative
Political Climate Minnesota leans slightly Democratic Hennepin County is more Democratic than others in the Minneapolis area Voters are somewhat pessimistic But not overly so; nationally voters are more pessimistic about the direction of the country Governor Dayton is fairly popular (54% favorability rating) The state legislature over all is not popular (52% unfavorable) but voters have a much more positive view of their own representative (57% favorability) Democrats have the advantage in the generic vote 5 The Long-Term Care Imperative
Background Caregivers: Roughly a fifth of voters are current caregivers Over half of Minnesota voters are currently, or have in the past been caregivers. Women and older voters are more likely to be caregivers % Caregiver % of each subgroup that is a caregiver Long-term care insurance and planning Fewer than a fifth of voters have long-term care insurance Less than half even have a plan for their long-term care expenses Most people with a plan will rely on their own personal savings to cover care costs Despite planning, a majority believe they will only be able to cover the basics % w/ LTC ins: <40: 15% 40-59: 17% 60+: 26% Long-term care insurance/plan LTC insurance LTC plan % w/ LTC plan: <40: 33% 40-59: 39% 60+: 44% 6 The Long-Term Care Imperative
Public Knowledge: Organizations and Issues Education MN is the best known organization followed by the AARP Long-term Care is as well known as the Hospital Association, however less popular. Voters report they are willing to pay more in taxes for a variety of issues Including improved access to care for Seniors Job creation is by far the most important issue for voters, followed by improving education and cutting spending. 7 The Long-Term Care Imperative
Education Minnesota And The AARP Are Most Recognized LTCI As Well Known As The Hospital Association, But Less Popular Favorability (ranked by mean) Mean (Scale 1-4, unfavorablefavorable) 2.75 2.69 2.59 2.52 8 The Long-Term Care Imperative 2011, page 8
Voters Are Willing To Pay More In Taxes To Improve Every Measure Tested More Than Six-In-Ten Willing To Pay More To Improve Long-Term Care % willing to pay more in taxes Provide better access to longterm care for seniors Provide better access to long term/nursing home care for seniors (cmbd) SS Provide better access to nursing home care for seniors 0 10 20 30 40 50 60 70 80 9 The Long-Term Care Imperative 2011, page 9
Voters Are Willing To Pay More In Taxes To Improve Every Measure Tested More Than Six-In-Ten Willing To Pay More To Improve Long-Term Care % willing to pay more in taxes 10 The Long-Term Care Imperative 2011, page 10
Job Creation Tops The List Of Priorities Among Younger Voters, Improving Education Just As Important As Jobs Priorities (ranked by top priority) 39 39 50 30 Issue <40 40-59 60+ 2 2 2 8 22 Jobs 48 51 52 Educ 49 35 33 Govt Spend 40 41 35 Health care 33 30 31 Long-term care 5 8 11 11 The Long-Term Care Imperative 2011, page 11
Impressions of Long-Term Care, Facilities and Terms Nursing Home is by far the most referenced phrase to describe longterm care Nursing homes are significantly less popular than other facilities In-home care is the most popular When asked about access, affordability is the first thing that comes to mind More voters believe long-term care providers c are about their bottom line more than about the seniors and families they serve. 12 The Long-Term Care Imperative
In your own words, what comes to mind when you hear the phrase long-term care for seniors? 13 The Long-Term Care Imperative
Affordability First Comes To Mind When Thinking About Access And That Is True Across Gender, Age Groups & Among Caregivers What characteristic first comes to mind when you think of the phrase access to long-term care? 14 The Long-Term Care Imperative
Slightly More Voters Feel Long-Term Care Providers Care More About Their Bottom Line Than Serving Seniors & Families Caregivers Have A More Positive View of Providers Which comes closest to your own view? 15 The Long-Term Care Imperative
In-Home Care Is Most Popular Phrase Tested Nursing Homes Is Least Popular Favorability (ranked by mean) Mean (Scale 0-100, unfavorable to favorable) 73 73 71 70 69 61 60 56 16 The Long-Term Care Imperative
Rating Aspects of Health Care When it comes to quality of care Voters feel quality lags at nursing homes but have a positive impression of quality of care at assisted living communities, and the care administered in a senior s own home Segmenting on how voters rate senior care: We segmented voters based on how they rate access to and quality of senior care, and senior s ability to stay independent in their own homes. The electorate was divided into: Most positive: (older voters [particularly older men] and Republicans [particularly men].) Somewhat positive: care givers, older women and Democrats Least positive: Younger voters, those without insurance and those without a long-term care plan 17 The Long-Term Care Imperative
Quality Of In-Home Care Perceived To Be Best, Nursing Home Care Worst Voters Have A More Positive Impression Of Access To Health Care Than Long-Term Care Rating Aspects of Health Care Net Negative 36 39 39 25 31 52 47 53 Net Positive 50 40 48 53 53 35 33 27 Mean 2.62 2.49 2.57 2.79 2.71 2.26 2.29 2.07 18 The Long-Term Care Imperative
Seniors, Republicans And Those With A Long-Term Health Plan Rate Senior Care Most Positively Those Without Insurance Are Least Positive Segmenting Senior Care Segmenting We segmented the electorate based on how they rated various aspects of senior care Using how they rate quality of & access to seniors care, and the ability of seniors to stay independent & in their own homes Most positive (38%) Seniors(43%) Older men (46%) GOP (44%), esp GOP Men (49%) Have a plan for long term care (49%) Somewhat positive (28%) Pay personally for insurance (36%) Caregiver (35%) Women 50+ (36%) Dem (32%) Least Positive (34%) No insurance (48%) <40 (46%) Independents (41%) Anoka/Ramsey/Dakota (38%) No long term care plan (37%) 19 The Long-Term Care Imperative
Rating Reform Specifics Proposals focused on improving the quality of care, or making it easier for seniors to age comfortably are most popular Increasing wages for caregivers and reinvesting cost savings are also popular. When it comes to paying for reform, voters support: Allowing people to cash in their life insurance policies to pay for their own care Raising taxes on the wealthy Voters oppose raising state sales tax to pay for reforms Encouraging is better than requiring when it comes to long-term care insurance. 20 The Long-Term Care Imperative
Improving Care And Making It Easier For Seniors To Stay Independent Is The Most Popular Proposal Tested % Favor/Oppose Reform Proposals Net Oppose Net Favor Total Fav-Opp 10 85 +75 14 78 +63 14 77 +63 19 73 +54 18 68 +50 21 68 +47 21 The Long-Term Care Imperative
Encouraging Is Better Than Requiring Rate Equalization Works Better Without Price Controls Even Among Republicans % Total Favor Tot Men Wmn Dem Ind Rep <40 40-59 60+ Require/Encourage People: Encourage people to have long-term care insurance to help them pay for their own care 75 77 73 75 75 81 82 80 61 Require/Encourage People: Require people to have long-term care insurance to help them pay for their own care Rate Equalization: Require those who can afford to pay for their own long-term care to pay for it in full 44 46 42 41 44 43 61 39 29 62 69 57 67 54 64 54 61 70 Rate Equalization: Require those who can afford to pay for their own long-term care to pay for it in full, rather than have the state impose price controls 51 54 48 48 51 54 41 55 57 22 The Long-Term Care Imperative
Increasing Funding Generally Makes Each Proposal Weaker Ensuring Increased Funding Will Not Increase The Budget Overall Makes The Proposal More Palatable; Voters Prefer The Rich Pay For Reform % Total Favor Tota l Men Wm n De m Ind Rep <40 40-59 60+ Nursing Homes: Improve the overall quality of care in nursing homes Nursing Homes: Increase funding for nursing homes so the overall quality of care improves 85 80 89 91 80 77 83 79 95 69 66 72 83 69 54 73 71 65 In-home/Community Care: Make it easier for seniors to stay independent and in their own homes longer 89 89 90 95 83 87 83 92 93 In-home/Community Care: Increase funding for in-home care and community centers, so seniors can stay independent and in their own homes longer 81 75 86 93 76 70 74 85 84 Increased Funding: Increase funding for long-term care 63 55 70 80 56 47 62 71 58 23 The Long-Term Care Imperative
Cost Savings, Rate Equalization & Personal Responsibility Cost savings Requiring cost savings be reinvested to improve care is popular on its own, though middle of the pack when compared to other proposals Rate equalization Voters are supportive of everyone paying their fair share, but when pitted against the other side, voters believe everyone should pay the same rate, though seniors are a bit more receptive to the argument than voters over all Personal responsibility Quality long-term care is a right every Minnesota senior has. Initially split on whether each person should save and pay for their own care, however after hearing messages for and against, more side with the state helping cover the cost of care The most conservative demographic groups still want individuals, not the state to pay for their own care Democrats, and more liberal groups favor the state providing help. 24 The Long-Term Care Imperative
As A Proposal, Voters Support Reinvesting Savings To Improve Care But With Options, They Are Divided Favor/Oppose Proposal: Require any state savings from longterm care reform be dedicated to senior care 62 20 25 The Long-Term Care Imperative
On Its Own Voters Support Requiring Everyone Pay The True Cost Of Their Care Seniors Are The Most Supportive, Younger Voters Are Divided % Favor Requiring People Pay True Cost 57 64 58 48 26 The Long-Term Care Imperative
But When Pitted Against Our Opponents Argument, More Side with Their Position Among Seniors the Margin is Closer Which comes closest to your own view about nursing home care? 27 The Long-Term Care Imperative
With Information from Both Sides, More Support the State Providing Help Now I m going to read you two statements about long-term care in Minnesota. After I read both I d like you to tell me with which of the two statements you agree with most, even if neither is exactly right: Statement A: More than two-thirds of aging Minnesotans are unprepared to pay for their own long-term care. If more seniors don t start saving and paying for their own care, the state will have to add three billion dollars to the budget each year to cover the cost. To save taxpayers money, Minnesotans should be responsible for saving and paying for their own care. Statement B: The average cost for one year of long-term care is 48 thousand dollars. These excessive costs require threequarters of Minnesota seniors to rely on the state to help them pay for their care. After seniors spend their entire lives working, the state should help pay for their long-term care. Personal Resp State Help: -12 40 52 28 The Long-Term Care Imperative
Messaging Minnesota has an opportunity to implement changes and reforms that will help it adjust to our growing senior population (and increased demand for service and rising costs.) To make the best use of every dollar the state spends on care, providers must be encouraged to explore opportunities to streamline and improve service delivery and efficiency. Senior care goes beyond nursing homes, and encompasses all types of long-term care. The state must not only protect nursing home services, but also must work to improve and protect the wide continuum of care that also includes in-home and independent care options. Long-term care is an economic engine that provides valuable jobs and economic development. 29 The Long-Term Care Imperative
Messaging Minnesotans are not prepared and cannot afford to pay for care without help there is an impending economic crisis as our populations ages. Minnesota has an opportunity to implement changes and reforms that will help it adjust to our growing senior population (and increased demand for service and rising costs.) To make the best use of every dollar the state spends on care, providers must be encouraged to explore opportunities to streamline and improve service delivery and efficiency. While everyone should pay their fair share, the state has an obligation to ensure that personal finances are not a barrier to accessing necessary care to age with dignity. 30 The Long-Term Care Imperative
Messaging Senior care goes beyond nursing homes, and encompasses all types of long-term care. The state must not only protect nursing home services, but also must work to improve and protect the wide continuum of care that also includes in-home and independent care options. Messages that focusing specifically on certain policies perform less well, in particular: Rate equalization, personal responsibility Opponents have strong messages too Broad messages focused on government spending and increased taxes are most effective for opposition (they work best with Republicans) A negative message focused on rate equalization resulting in different levels of care is damaging (particularly among Democrats and younger women) 31 The Long-Term Care Imperative
Making It Easier For Seniors To Age Safely & Independently Is Our Best Message Messages On Caregivers, Solving This Growing Problem & The Economy Are Also Strong % very convincing reason to SUPPORT reform 32 The Long-Term Care Imperative
Negatives Focused On Taxes & Govt Spending Are Most Damning And A Message Against Rate Equalization Repeal Holds Water Too % very convincing reason to OPPOSE reform 33 The Long-Term Care Imperative
The Top Positive And Top Negative Perform Similarly Well Regarding Rate Equalization, Their Negative Message Performs Better Than Our Positive % very convincing reason to SUPPORT/OPPOSE reform Positive Message: Negative Message: 34 The Long-Term Care Imperative
Recommendations Keep our reform message focused on seniors and improving care Argument should be broad, and focused on providing better care for seniors Reform is about: Improving care for seniors first and foremost Addressing a looming crisis in our state Improving conditions for caregivers By doing these things we will be improving the economy. Make senior care about more than nursing homes, or providers nursing home is clearly the connotation when referring to long-term care, but it is far less popular than other forms of care Providers in general are perceived to care more about their bottom line than providing quality care Continue to make community based care (in-home, assisted living centers) a key part of all public communications so when people think senior care they think about more than nursing homes We must expand the definition of long-term care and senior care 35 The Long-Term Care Imperative