
Robert Eaton
Principal & Consulting Actuary at Milliman specializing in long-term care insurance, life insurance, and health products.
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Jun 10, 2026
Dementia Neurology Deserts and Long-Term Care Insurance Claims Experience in the United States
6:04
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7:22
15:38
15:52

Robert EatonGUEST
report?We wanted to examine, you know, were there places, uh, in the, in the US that had more cognitive-based long-term care incidence rates than we might otherwise expect, or were there places where we would have fewer cognitive claim incidence rates? And so, uh, collecting this data across, uh, on a, in a nationwide basis and looking at it by, uh, the states that the policy holders are in, we created kind of state-by-state scores and mapped against the nationwide average, uh, how much did the state of, you know, Kentucky or Alabama or, or Maine, h- how much, uh, were their cognitive incidence rates compared with, you know, the nationwide average? Were they particularly higher or lower? And we were interested in, in trying to understand, is there a relationship between places where there might be much higher or much lower cognitive incidence rates for long-term care claims than there were the supply of neurologists? And Dr.

Robert EatonGUEST
Rao has worked on a paper, uh, that I'll let her describe on neurology deserts, and that's really kind of the marriage of the work that she's done, uh, with the supply of neurologists, and the data that we collected, uh, the actuarial data, the historical long-term care experience data, and kind of putting those two together.

Robert EatonGUEST
So, you know, what we found is there's a small but modest correlation, 10% correlation between the supply of neurologists and, uh, the cognitive incidence rate relativity for long-term care claims in our historical window.
8 MINS LATER

Robert EatonGUEST
One thing that I, I really wanna highlight that Dr. Rao has brought up, and, and Dr. Rao, you did a great job of this, if you'll remember at the second Long-Term Care Medical Symposium that the Society of Actuaries sponsored.

Robert EatonGUEST
These are some of the external factors, Dale, that I don't know that a lot of actuaries can really do a great job of planning for.
