The LTC Inforce Toolbox: 5 Strategies to Manage Today’s Blocks for Tomorrow’s Obligations

The standalone long-term care (LTC) insurance market has certainly changed over the past 20+ years.

For most carriers today, the focus is no longer on expanding new sales. Instead, the priority is managing existing inforce blocks in a way that supports quality care for policyholders while also maintaining the long-term financial strength needed to pay claims for decades to come.

Carriers must navigate uncertainty around morbidity and utilization trends, rising costs of care, and an aging policyholder population. At the same time, they also face significant regulatory scrutiny and the need to maintain trust with policyholders and stakeholders.

No single strategy can address it all. Success requires a coordinated approach that ties in multiple capabilities across an organization.

I call this collection of capabilities the “LTC Inforce Toolbox”—a set of strategies to help carriers rebuild and improve outcomes across claims management, cost control, financial performance, and customer experience.

What’s in the Toolbox?

Carriers have access to multiple tools that can help address and manage LTC block risks and costs. Integrating multiple tools and deploying them in a coordinated way can help optimize the management of a block. Below are 5 key tools that carriers can leverage.

Tool #1: Operational Excellence

Operational excellence is the foundation that enables every other strategy to succeed.

Efficient claims processing, accurate claim decisions, strong data and analytics capabilities, scalable operating models, and effective vendor management all contribute to better outcomes and a better experience for policyholders and claimants.

Just as importantly, operational excellence creates the infrastructure needed to support innovation. Whether a carrier is implementing advanced analytics, expanding wellness programs, or enhancing FWA detection, success ultimately depends on having the right processes, technology and operating model in place.

Tool #2: Wellness Programs

The goal of wellness programs is to engage policyholders and support health, independence, and overall well-being. By helping individuals remain healthier for longer periods, carriers may be able to delay the onset of claims or reduce claim severity.

The potential benefits extend beyond financial outcomes. Wellness initiatives can also enhance customer satisfaction by providing policyholders with meaningful support throughout their coverage rather than only during a claim event.

Despite their potential, wellness programs lack credibility due to their newness and challenges with policyholder engagement. The value of wellness programs depends on reaching the right policyholder at the right time with the right intervention. Wellness programs also are one of the few tools that provides a positive experience from the policyholder’s perspective. As carriers improve their ability to identify emerging risks and personalize outreach, wellness programs could become a much more significant contributor to inforce management.

Tool #3: Anti-Fraud, Waste & Abuse (FWA)

As claim volumes increase and care delivery becomes more complex, effective FWA management is crucial. FWA initiatives target a range of issues, including billing inaccuracies, improper use of benefits, and intentional fraudulent activity. Modern programs increasingly rely on advanced analytics and AI to identify anomalies.

These capabilities can be complemented by payment reviews, surveillance activities, facility interviews, and targeted investigations. Together, these approaches help carriers identify potential issues more quickly and intervene before unnecessary costs accumulate.

Effective FWA programs ultimately help protect the integrity of the LTC block and preserve resources for the claimants who genuinely need care.

Tool #4: Preferred Provider Networks (PPNs)

Another increasingly important tool is the development of PPNs. By establishing relationships with vetted care providers, carriers can improve consistency in care delivery while creating opportunities for more predictable pricing arrangements.

For claimants, access to high-quality providers can contribute to more predictability and better care experiences and outcomes. For carriers, network relationships can support cost management through negotiated rates and more effective care coordination.

However, policyholders value choice, particularly when selecting caregivers or care providers. Carriers must design network models and incentives that encourage participation without creating unnecessary friction for claimants.

Tool #5: Rate Increases

Rate increases remain one of the most utilized tools available to LTC carriers. While not desired and often challenging to implement, they play a critical role in ensuring carriers can continue meeting their obligations to policyholders over the long term.

The purpose of a rate increase is to align pricing with experience and assumptions. As carriers gain additional insight into claim behavior, utilization patterns, and economic conditions, premium adjustments may become necessary to support block sustainability.

Rate increases come with challenges. They can create a negative experience for policyholders and pose reputational risk for carriers. Additionally, regulatory approval and implementation can take months or years before financial impacts are fully realized. As a result, insurers are increasingly seeking to utilize other inforce strategies in combination with rate increases.

Bringing the Toolbox Together

Effectively managing an LTC block requires more than any single initiative. Meaningful results are often achieved by combining multiple strategies, sequencing them thoughtfully, and using data-driven insights to adapt over time. Success also depends on close collaboration across actuarial, claims, operations, finance, and executive leadership.

The challenges facing LTC blocks did not emerge overnight, and sustainable solutions will not come from a one-time action. As the toolbox evolves, so will our understanding of how these capabilities can work together to improve outcomes, manage risk, and support the long-term sustainability of LTC blocks.