Shot of a young nurse caring for a senior man in a retirement home

Informal caregivers potentially provide billions of dollars worth of unpaid care to loved ones each year, but federal and state solutions to address this problem often yield only minor relief. The problem, according to the Society of Actuaries Research Institute, comes down to data and politics. 

“Caregiving has been getting more national attention of late, with the Biden administration’s executive order in the spring, the new GUIDE program and discussion on caregiving,” Matthew Smith, a consulting actuary for Milliman, said in a statement to McKnight’s Home Care Daily Pulse.

Smith, who co-authored SOA Research Institute’s report titled “Informal Caregiving: Measuring the Cost and Reducing the Burden,” said that the success and scalability of many caregiver support programs often depends on their ability to demonstrate their impact. State programs such as WA Cares or California’s Long-Term Care Insurance Task Force are two promising solutions to alleviating caregivers’ financial burdens, he said, but evidence will be necessary for continued growth.

“It will be important to monitor which programs have the most clear and significant impacts in practice. The most successful programs could then have a relatively easier time getting more traction in other states or possibly from the federal government itself,” Smith said.

The most important observable metrics for successful caregiver support programs, he noted, are their ability to reduce the need for institutional care, reduce hospital and emergency department visits, and alleviate the financial burden on caregivers. 

The new federal Guiding an Improved Dementia Experience (GUIDE) Model offers an innovative respite care offering for caregivers of people with dementia. But like state programs, the federal program’s ability to demonstrate value through data will be key to securing ongoing support.

“The fate of caregiving reform efforts will largely be a political question,” Smith noted. “Numbers and metrics can inform and support decisions, but politicians will ultimately have the final say on which programs get advanced.”

The recently finalized physician fee schedule includes Medicare payments for practitioners who train caregivers to support patients with certain diseases or illnesses (such as dementia) in carrying out treatment plans.