West Virginia highest in LTC claims frequency

5 states stand out in report

These are some more findings from the  Aon Risk Solutions' "2011 Long Term Care General Liability and Professional Liability Actuarial Analysis":

West Virginia has the highest frequency of claims and loss rate per occupied long term care bed in the study. The state also has the second highest projected severity and loss rate as a percent of the Medicaid per diem reimbursement rate.

Claims frequency is expected to be 1.29% in 2011 and the loss rate per occupied long-term care bed in West Virginia is $3,900, which is more than three times what it was in 2003 ($1,100). West Virginia has the second highest projected severity at $302,000. The loss rate as a percent of the Medicaid per diem reimbursement rate is at 5.34%, which is the second highest in the study.

Kentucky's loss rate has increased over the past 10 years and has been more than $3,000 per occupied bed in four of the past five years. The projected loss rate in 2011 is $3,230, the second highest of the profiled states. The projected 2011 frequency of 1.15% is second highest of the profiled states. The projected severity is $281,000. The loss rate as a percentage of the Medicaid per diem reimbursement rate is 5.82%, placing Kentucky highest among the profiled states.

Tennessee's claim severity is projected to be $312,000 in 2011, which is the highest in the study, while claims frequency is expected to be at 0.84%, the fifth highest among profiled states in the study. The loss rate dropped from a high of $3,370 in 2003 and is projected to be $2,620 for 2011, the third highest loss rate of the states profiled in the study. Tennessee's loss rate as a percent of the Medicaid per diem reimbursement rate also has dropped from a high of 8.46% in 2003 to 4.83% in 2010. Despite dropping by nearly half, this rate stands out as the third highest of the profiled states.

California has a projected loss rate per occupied long-term care bed of $2,020 in 2011, which is the fourth highest loss rate in the study. Claim frequency has been stable since 2008, and the projected 2011 severity is $192,000. The loss rate as a percentage of the Medicaid per diem reimbursement rate has been less than 4% since 2005.

Texas had the second highest loss rate in the study in 2003, the year its tort reforms were enacted. Texas now maintains the lowest projected loss rate in the nation at $330. In addition, Texas has the lowest 2011 forecasted severity at $73,000 and the second lowest frequency of claims at 0.45%. The Medicaid per diem for Texas is 0.70%.