Development and Testing of a Long-Term Care Cost Planning and Education Tool for Caregivers

Background and Purpose: An estimated 52% of Americans over 65 years old will need high levels of long-term care (Favreault & Dey, 2016), but most have not planned for their long-term care needs nor saved enough to cover the high cost of long-term care (AP-NORC Center for Public Affairs Research, 2014). Medicaid provides a critical safety net for those who have exhausted their savings and require skilled care, but the complexity of Medicaid eligibility rules and covered care options create barriers to enrollment. We developed “Moai Caregiver,” the first website to provide state-specific and personalized Medicaid enrollment timelines for older adults who need long-term services and support (LTSS). Designed to reduce information overload for informal caregivers, the website educates caregivers and alleviates burden by providing information on what financial resources the care recipient may qualify for.

Methods: In this study, 112 caregivers of adults aged 60+ were recruited to interact with and complete specified tasks on the Moai Caregiver website in unmoderated usability testing sessions. Participants answered usability and user satisfaction questions and provided running verbal commentary. Participants also completed a Medicaid knowledge test before and after using the website. Video-recorded sessions were analyzed using rapid qualitative insights and descriptive statistics.

Results:

Results indicated that using the website and watching four Medicaid explainer videos embedded in the site significantly improved participants’ Medicaid program knowledge (t=13.3, p<.001). The mean score on the pretest was 43.5% correct (SD=.18) and the mean score on the posttest was 68.5% (SD=0.15). Additionally, participants found it easy to enter the care recipient’s financial information to determine their Medicaid eligibility (mean= 5.9/7, SD=1.4). They understood why they were being asked to enter the financial details of the person they care for (mean=4.9/5, SD=.44,), rated the Care Cost Calculator as very helpful (mean=6.3/7, SD=1.2) and strongly agreed that they learned how much long-term care costs in their area (mean=4.43/5, SD=.91).

Discussion and Implications:

Long-term care planning is often a stressful and complex process for family caregivers, particularly when faced with the intricacies of Medicaid enrollment. While many individuals and their care partners could benefit from Medicaid, the lack of clear, simplified information often prevents effective planning and may delay access to care. This study highlights that embedding explainer videos can be a highly effective tool in educating caregivers about Medicaid eligibility rules. The majority of participants not only gained new knowledge, they expressed comfort in entering financial information into the website to determine eligibility for Medicaid. This suggests that clear communication and accessible resources can significantly ease the burden of navigating long-term care planning.