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Actuarial Research Topics for Long Term Services and Supports (LTSS)

Background and Purpose

With increasing life expectancy and medical advances, growing numbers of people require long term services and supports (LTSS) to help them cope with a variety of daily living activities. Support can range from minor assistance such as balancing a checkbook to more personal hands-on help with needs such as toileting and bathing, or caring for individuals with severe cognitive limitations. The specific need for services is primarily due to aging, chronic illnesses, disabilities, or a combination of these factors. With the aging of the population, the demand for LTSS services will likely continue to grow steadily and the care needs themselves become more intensive and longer lasting. These services encompass various types of care, including personal care, medical care, and support services, which can be provided at home, in community settings, or in specialized institutions like nursing homes.

While the primary goals of LTSS include helping individuals maintain their independence, providing them support in appropriate home settings and improving their quality of life despite health limitations, the implications of such care can present significant challenges for both individuals and families. The stress of the care needs can be felt in various ways by formal or informal caregivers, with consequences ranging from physical and mental stress on the part of caregivers, burnout and potential loss of caregivers, financial strain and even the eventual exhaustion of all resources. There are several options for financing care needs, each with advantages and disadvantages that fall short of a comprehensive solution for all stakeholders.

Given the current piecemeal state of LTSS services in the U.S., the Society of Actuaries (SOA) Research Institute’s Aging and Retirement program is interested in an exploration of these services from a variety of actuarial perspectives. The result of this effort is intended to provide a useful resource for readers to become well-grounded on the issues surrounding the impact of these services and set the stage for future research. Note: While Medicare, Medicaid, and Veterans’ Affairs benefits have an impact on LTSS services, these programs are considered out of scope for this request for research proposals and essays.

In recognition of the importance of this topic, the Aging and Retirement program is simultaneously issuing both a request for research proposals and a call for essays. The dual objectives of this effort are to:

  1. Sponsor a research project that provides an in-depth and expanded view on a topic related to these issues.
  2. Publish a collection of essays that represent a broad range of perspectives on these issues.

The next section of this document highlights topics that might be considered for both the request for proposals and call for essays.

Additional submission requirements for proposals and essays are described in the subsequent sections.

Research Objective

The sponsors are seeking researchers and essayists to explore actuarial aspects of LTSS. The desired combined end product of this effort is a resource that will aid in the understanding of relevant issues while providing current considerations and potential future dynamics of LTSS.

The intended audience for this effort includes actuaries and other long-term care planning professionals.

The following are illustrative of the topics and questions that might be addressed in an essay or research project. Respondents to this RFP/Call for Essays are not required or expected to address all or even any of these topics/questions. Rather they are encouraged to also consider other question(s) or topic(s) they deem critical to the work done by the Society of Actuaries Research Institute and its members. To maintain a reasonable scope, researchers should be selective in the number of topics/questions they cover.

Possible topics for examination include:

Demographic Trends

  • How do current population aging trends impact LTSS demand and costs?
  • How do potential changes in family structure impact provision of services? For example, in what ways will caregiving need to change if fewer family members are available to help with these needs?
  • What are the financial effects of population growth on LTSS?
  • What are differences in the provision of LTSS for young, middle-age and older age individuals?
  • What are the gender differences in long-term support services utilization and the financial implications of those differences?
  • What are the differences in access to and costs of LTSS between urban and rural areas?
  • What is the financial impact of baby boomers having greater LTSS needs as they age in the next decade and beyond?
  • How do current and potential future shortages of care workers impact the provision of LTSS?
  • What different issues exist for informal care (i.e., family or friends) and paid-for caregivers, either at home or in facilities?

Artificial Intelligence

  • What is/will be the role of Artificial Intelligence in providing and managing LTSS and related administrative aspects of caregiving?
  • How can Artificial Intelligence prevent fraud and other financial risks that those needing LTSS may encounter?
  • What are potential uses of Artificial Intelligence in addressing engagement and companionship needs of people in need of LTSS?
  • In what ways can Artificial Intelligence improve the delivery of LTSS services?

Health Outcomes

  • How does chronic disease prevalence affect LTSS utilization and costs?
  • What are the financial impacts of neurological-related diseases, such as dementia and Alzheimer’s disease, on LTSS and how might this change in the future? Which related costs for caregiving and medical treatment may grow the most in the future and which may be reduced?
  • What is the cost-benefit of specialized physical rehabilitation and recovery services for LTSS?

Service Delivery

  • How can the cost and quality of support services in different settings (home vs institutions vs day programs, etc.) best be assessed?
  • What are the cost-benefit implications of technological advancements in LTSS?
  • How do workforce challenges impact the provision and costs of LTSS?
  • How can medical, personal and other support services be integrated to optimize costs and outcomes?
  • What are the financial implications of telehealth and remote monitoring in LTSS?
  • What are ways that home care can be expanded to provide more efficiency and cost reduction to LTSS?
  • What services and care strategies could help best meet the needs of individuals with memory and cognitive care needs?
  • What are the impacts of hospice and palliative care for the delivery of LTSS?

Planning and Financing

  • What are ways that LTSS can best be integrated into retirement planning?
  • How do financial literacy and education shortfalls about LTSS needs impact younger generations (Gen Z, etc.) when it comes to future planning?
  • How can the future cost of LTSS be identified and quantified for planning and savings purposes?
  • What are the latest developments in products that combine long-term care (LTC) and other coverages (combination products)?
  • What are the implications of using 401(k) and similar plans to finance LTSS and long term care needs?
  • What lessons can be learned from other countries to enhance LTSS planning and financing?
  • What are the advantages and disadvantages of using home equity to finance LTSS needs?
  • How can private-sector LTC insurance and public sector provision (e.g., Medicaid and Medicare) be better coordinated and delivered?
  • What is the potential intersection of private and public financing approaches in the provision of LTSS? How do these approaches balance against one another to achieve the desired outcomes?

Prevention

  • What types of services and care may prevent or minimize the need for more intensive LTSS services in the future?
  • To what extent have preventative services been integrated into the provision of other LTSS services? What services may be well-integrated and which are lacking?

Again, the list above is not meant to be exhaustive but merely examples of topics that may be examined in an essay or research project.

Rules for Submission of Essays

Timeline

The deadline for submissions is June 30, 2025. Essays will be published in a formal collection as soon as possible.

Length and Instructions for Submission

Essays should be submitted in English with a desired length of between 500 to 2,500 words. There is no requirement for formal or extensive footnoting.

Author information must be submitted with the essay and include name; credentials or designations (if appropriate); title; organization/company; e-mail address; and phone number. Please provide all author information at the beginning of the essay. 

Essays that contain any overt political statements, commercial content, and other inappropriate material will not be accepted. Articles must comply with the SOA's antitrust guidelines.

Please submit your essay via e–mail to Research-AR@soa.org.

Awards

$5,000 in award money has been allocated for this call for essays. The review committee will select the leading essays and determine how to allocate the award money among them. Consideration will be given to creativity, originality and the extent to which an idea might help promote further research or thought in this area. In exchange for award money, selected authors will be required to assign all copyrights in their essays to the Society of Actuaries Research Institute.

Authors are ineligible for awards if an essay is based on an Institute-sponsored and funded research study conducted by the author. However, authors are welcome to submit such essays for publication consideration.

Publication and Presentation

Depending on how many essays are received and the range of the topic areas, a suitable format for electronic publication and dissemination will be selected. Essays may also be presented at an SOA meeting, webcast, or other professional development event.

In addition, other venues for publication or presentation of the ideas outside of the Institute will be considered. It is hoped that publication of the collected essays will further knowledge and stimulate discussion as well as promote future efforts.

Rights Granted

Please understand that by submitting an essay for consideration, the essay author(s) is granting to the Society of Actuaries Research Institute an unlimited license to print or republish their essay, with proper attribution given to the author(s).

Questions

Please direct any questions regarding this Call for Essays to Research-AR@soa.org.

Rules for Submission of Research Proposals

Proposal Requirements

To facilitate the evaluation of proposals, the following information should be submitted:

A. Resumes of the researcher(s), including any graduate student(s) expected to participate, indicating how their background, education and experience bear on their qualifications to undertake the research. If more than one researcher is involved, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the researchers as well as for the firm or institution on whose behalf the proposal is submitted.

B. An outline of the approach to be used (e.g. literature search, model, etc.), emphasizing issues that require special consideration. Details should be given regarding the techniques to be used, collateral material to be consulted, and possible limitations of the analysis.

C. A description of the expected deliverables and any supporting data, tools or other resources.

D. Cost estimates for the research, including computer time, salaries, report preparation, material costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included. Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor.

E. A schedule for completion of the research, identifying key dates or time frames for research completion and report submissions. The sponsors are interested in completing this project in a timely manner. Suggestions in the proposal for ensuring timely delivery, such as fee adjustments, are encouraged.

F. Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.

Selection Process

The SOA Research Institute will appoint a Project Oversight Group (POG) to oversee the project. The Institute is responsible for recommending the proposal to be funded. Input from other knowledgeable individuals also may be sought, but the Institute will make the final recommendation, subject to Society of Actuaries Research Institute (SOA) leadership approval. A staff research actuary will provide staff actuarial support.

Questions

Any questions regarding this RFP should be directed to Research-AR@soa.org.

Notification of Intent to Submit Proposal

If you intend to submit a proposal, please email written notification by June 15, 2025 to Research-AR@soa.org.

Submission of Proposal

Please email your proposal to Research-AR@soa.org; proposals must be received no later than June 30, 2025.

Conflict of Interest

You agree to disclose any of your material business, financial and organizational interests and affiliations which are or may be construed to be reasonably related to the interest, activities and programs of the Society of Actuaries Research Institute.

Appendix

The cost ranges below are intended as a guide for budgeting project costs for proposals in response to SOA Research Institute Request for Proposals (RFP). Please note these figures span the 33rd to 66th percentiles for all projects as well as projects that involve a specific approach (lit review, survey, etc.). They are based on historical costs over several recent years. Expected costs for some RFPs may fall outside these ranges depending on the nature of the work and resources required for completion.

All Contracted Projects

This category includes all contracted projects that the Institute has undertaken within the last several years.

The 33rd-66th percentile project costs range is $25,000 - $50,000.

Literature Reviews

This category includes projects that involved only a literature review or the cost for the portion of a larger project that included a literature review.

The 33rd-66th percentile project costs range is $15,000 - $20,000.

Surveys

This category includes all projects that had a survey as their primary component.

The 33rd-66th percentile project costs range is $28,000 - $55,000.