LONG-TERM CARE SEMINAR SERIES
Monthly on the 3rd Thursday
8am US Pacific Time, 11am US Eastern Time, 5pm Central European Time
The Gateway to Global Aging, in partnership with the Center to Accelerate Population Research in Alzheimer’s (capra.med.umich.edu), is organizing a monthly virtual seminar series on long-term care, services, and policy. The seminar series is led by Courtney Van Houtven from Duke University and Giacomo Pasini from Ca' Foscari University of Venice. The goal of the seminar series is to promote international interactions among scholars in this growing field of research. Presentations will typically be on in-progress work and discussions are strongly encouraged.
Participants must register to receive upcoming seminar announcements and virtual meeting room links. To register please submit a form with your email here. Emails will be kept limited to seminar announcements and you can unsubscribe from this list at any time.
Upcoming Presentations:
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February 19, 2026
Sara Machado, Brown University
"Cognitive Decline and Retirement Planning and Behavior: Evidence from European Statutory Retirement Age Increases"
Many high-income countries have raised statutory retirement ages (SRAs) to extend working lives, yet whether all workers can adapt to these changes remains unclear. Cognitive impairment poses a particular challenge: individuals experiencing cognitive decline may exit the labor force earlier rather than extending their working lives when SRAs increase. This study examines whether SRA increases lead to extended working lives or earlier labor force exits and pension claiming among individuals experiencing cognitive decline. We exploit pension reforms implemented in 2013 in Spain and the Netherlands as natural experiments using a quasi-experimental difference-in-differences design. These reforms gradually increased SRAs from 65 to 67 years. We compare adjustment patterns to nine control countries with stable SRAs during 2004-2023 using data from SHARE, ELSA, and HRS. We measure within-person cognitive changes using standardized word recall scores and examine effects on expected retirement age, probability of working full-time at age 63, and actual pension claiming behavior. Preliminary observational evidence indicates cognitive decline is associated with earlier retirement: for every 30 men (26 women) experiencing one-standard deviation cognitive decline, one expects to retire a year earlier. Findings will inform understanding of how pension reforms affect workforce composition and whether policies intended to extend working lives may inadvertently create earlier exit pathways for vulnerable older workers.
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March 19, 2026
Brian McGarry, University of Rochester
"The Effects of Nursing Home Staffing on the Quality of Nursing Home Care: Evidence from Employee Absences"
Nursing homes provide critical long-term and post-acute care to older adults, yet persistently low care quality remains a pressing policy issue in this industry. Direct care staffing—provided by certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs)—is a key determinant of quality, but there is limited consensus on optimal staffing levels and skill mix. Using daily employee-level nursing home staffing data, this study leverages day-to-day staffing shocks caused by employee absences to causally estimate the effects of staffing levels and skill mix on patient outcomes. We find that, on average, nursing homes are only able to replace 82% of lost staff hours when an employee is absent with wide variation around this mean. Instrumenting for potentially endogenous staffing levels with our absence instrument, we find that a 25% increase in the weekly staff-to-resident ratio results in a 15% reduction in the share of residents hospitalized and a 15.1% reduction in the share of patients who die in that week, as well as an 11% and 13% reduction in days spent in the hospital and overall spending on inpatient care. Quality effects were largest from increases in CNA staffing levels, consistent with this staff type providing the preponderance of daily hands-on patient care. Quality returns to staffing were also the largest for facilities with the lowest baseline staffing levels, suggesting that minimum staffing standards may be an effective way to improve nursing home quality.
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April 16, 2026
Afriem Behailu Belete, University of Trieste
“From Pflegestufe to Pflegegrade: A Difference-in-Differences Evaluation of Germany's 2017 Long-Term Care Policy Reform Impact on the Receipt of Any Formal or Informal Care”
Germany introduced mandatory long-term care insurance (LTCI) in 1995 as the fifth pillar of its social security system, alongside health, pension, accident, and unemployment insurance (Social Code Book, Part XI). Since its introduction, LTCI of Germany has focused on individuals with physical limitations, excluding people with cognitive impairments like dementia and Alzheimer's disease. However, the 2017 long-term care policy reform considers not only physical impairments but also psychological and cognitive limitations, such as dementia. Since then, the long-term care (LTC) system ensures equal access to benefits for all individuals in need of care, regardless of whether their impairments are physical, mental, or psychological. Our paper asks whether the 2017 reforms to eligibility rules have affected the receipt of long-term care services in Germany. To respond to our research question, we use micro panel data from five waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) for Germany, comparing two waves before the reform (2013–2015) with three waves after (2017–2022), and we employ the difference in differences approach. Our key result indicates that individuals who gained eligibility after 2017 experienced an 8.9 percentage-point increase in the likelihood of receiving any formal or informal care, compared to those who remained ineligible. These findings suggest that the reform is effective in bringing previously overlooked older adults, especially those with cognitive impairments, into Germany's care system.
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May 21, 2026
Hyunjee Kim, Oregon Health & Science University
"Regular Medicaid home visits and emergency department use among older adults during extreme heat"
We studied the association between regular Medicaid home visits in the month before extreme heat events and emergency department (ED) visits during heat events among dual-eligible enrollees 65 years or older. We found an increase in ED visits during extreme heat. The increase in ED visits was similar among dual-eligible enrollees who received regular Medicaid home visits in the preceding month and those who did not. Our findings suggest that pre-heat home visits were not associated with reduced ED visits during heat events, but they may have helped facilitate timely care-seeking when heat-related symptoms arose.
Thank you to those who have already presented:
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January 19, 2023
Julien Bergeot of the Department of Economics, Ca’ Foscari University of Venice (joint work with Louis Arnault)
"Informal Care & Mental Health: A Story of Unobserved Heterogeneity"
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February 16, 2023
Marlies Bär of the Erasmus School of Health Policy & Management, Erasmus University Rotterdam (joint work with Pieter Bakx, Nigel Rice, Rita Santos, Luigi Siciliani, and Bram Wouterse)
"Spillovers of Delayed Nursing Home Admissions to the Hospital Sector"
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March 16, 2023
Edward Norton, University of Michigan
"Did Avoiding Post-Acute SNF Care During COVID Save Lives?"
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April 20, 2023
Ingo Kolodziej of RWI Essen (joint work with Norma B. Coe of the University of Pennsylvania and Courtney H. Van Houtven of Duke University)
"Intensive Informal Care and Impairments in Work Productivity and Activity"
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May 18, 2023
Joan Costa-i-Font, London School of Economics
"Are Long term care subsidies and supports productive? Effects on health and wellbeing"
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September 21, 2023
Elsa Perdrix, Paris Dauphine University
"Horizontal Inequity in Long-term Care Use in France"
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October 19, 2023
Bertrand Achou, University of Groningen
"At Home versus in a Nursing Home: Long-term Care Settings and Marginal Utility"
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November 16, 2023
R. Tamara Konetzka, University of Chicago
"The Role of Medicaid Home- and Community-Based Services in Use of Medicare Post-Acute Care"
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Dec 14, 2023
Anne Penneau, Institute for Research and Information in Health Economics "The Impact of Nursing Homes on Quality of Drug Prescription in France"
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February 15, 2024
Helena M. Hernandez-Pizarro, Pompeu Fabra University
"Unravelling Hidden Inequities in a Universal Public Long-Term Care System"
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March 21, 2024
Sung Ah Bahk, American University (joint work with Selin Secil Akin, Lidia Brun, Ignacio Gonzalez, and Aina Puig)
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5599570
"Universal Long-term Care Reform and the Labor Supply of Caregivers: Evidence from Korea"
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April 18, 2024
Meghan Skira, University of Georgia
"Genetic Risk for Alzheimer’s Disease and Related Dementias: Cognition, Economic Behavior, and Clinically Actionable Information"
https://www.nber.org/system/files/working_papers/w32181/w32181.pdf
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May 16, 2024
Wenhan Zhang, Duke University
"Trends in Quality of Life Indicators for Older Adults with Cognitive Impairment Across Living and Care Arrangements from 2008 to 2020: A Population-Based Descriptive Study"
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September 19, 2024
Bram Wouterse, Erasmus School of Health Policy & Management (joint work with Prithviraj Basu Mallik and Pieter Bakx)
"Preventing Nursing Home Use: Is State-Sponsored Spending for Social Care a Winning Formula?"
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October 10, 2024
Chuxuan Sun, University of Pennsylvania
"The costs of AD/ADRD by dementia subtype: Evidence from ACT"
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November 21, 2024
Manuel V. Montesinos, ROCKWOOL Foundation Berlin
"Elderly Care across Europe: The Role of Formal and Informal Care in Family Decision-Making"
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December 12, 2024
Elena Bassoli, ETH Zürich (joint work with Mathieu Lefebvre and Jérôme Schoenmaekers)
https://www.sciencedirect.com/science/article/pii/S0277953625008640
"Comparing Health Outcomes in Different Care Settings: Nursing Homes vs. Home Care"
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January 16, 2025
Gopi Shah Goda, Brookings Institution
"Subsidizing Medical Spending through the Tax Code: Take-Up, Targeting and the Cost of Claiming"
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February 20, 2025
David Li, University of Southern California (joint work with Marco Angrisani and Jinkook Lee)
"The Mental Health Implications of Informal Care Receipt Stability"
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March 20, 2025
Eric Bonsang, Université Paris-Dauphine
"The “Demise of the Caregiving Daughter”? Gender Employment Gaps and the use of formal and informal care in Europe"
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April 17, 2025
Megan Shepherd-Banigan, Duke University
"VA CARES: A partnered evaluation of the US Department of Veterans Affairs Caregiver Support Program"
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May 15, 2025
Jun Li , Syracuse University (joint work with Reagan A. Baughman)
"Wage Pass-Through Policies, Direct Care Worker Compensation, and Labor Supply in the Home Health Care Sector"
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September 18, 2025
Ritesh Maharaj (joint work with Sara Machado and Irene Papanicolas), Brown University
"The Impact of Long-Term Care Funding on Access to Life Sustaining Critical Care in the English NHS."
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October 16, 2025
David Knapp, University of Southern California (joint work with Maya Fransz-Myers, Sarah Gao, and the Gateway LTC Policy Team)
"Differences in Access to Publicly Provided Long-term Care in the United States"
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November 20, 2025
Stipica Mudrazija, University of Washington
"Life after care cessation: variations in labor market and earnings trajectories between former family caregivers and non-caregivers of older adults following the death of a loved one"
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December 11, 2025
Wei Yang, King's College London
"Can long-term care insurance reduce catastrophic health and long-term care expenditures among older adults? A quasi-experimental study in China"
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January 15, 2026
Jinbao Zhang, University of Kent
"The Effect of Self-Directed Care on Unmet Needs of Older Adults: Quasi-Experimental Evidence from China"