In a recent podcast, I talked with Dr. Anthony Zizza, medical director of Element Care, about the Program for All-Inclusive Care for the Elderly (PACE) that provides comprehensive care to low-income older adults. Unlike the piecemeal approach of most healthcare in the United States, participants in PACE receive one-stop-shopping for all their health needs. PACE is available to patients who have both Medicare and Medicaid (MassHealth in Massachusetts, where Element Care is located) and agree to receive all their care through the PACE program. Medicare and Medicaid pay a fixed amount per participant, which gives the program a financial incentive to keep them healthy and living in the community. As a result, many PACE programs offer nonmedical as well as medical care. W…

I clean the filter on my septic system twice per year – an awful job that I handle myself because it’s fairly quick and easy, despite how gross it is. I still remember the septic guy’s technique for remembering when to do it: “Check it at spring training and the World Series.” This spaces it out twice a year, when it’s not covered in snow. In financial planning, we can use another calendar event as a similar reminder to perform a quick financial checkup: the middle of the year. Mid-year is a good time to go back to your New Year’s resolutions, if any of them were financial, and recommit as necessary. A few items that are always worth reviewing:…

In recent years, Massachusetts has taken significant steps to improve care for seniors, most notably the Act to Improve Quality and Oversight of Long-Term Care. In a recent Risking Old Age in America podcast, Rep. Thomas M. Stanley, Co-chair of the Elder Affairs Committee, describes this initiative as well as further steps in the works. These include creating a family caregiver commission, licensing home health agencies, and working towards universal long-term care insurance. Here are some excerpts from our conversation: Senior Living Facilities Risking Old Age in America (ROA): You have been working [to make improvements] across the whole continuum of care from nursing homes [to] assisted living facilities to home healthcare. Please talk about the legislature’s initiatives in these areas. Rep. Thomas…

I recently met with a 71-year-old retiree who relies on Social Security for a sizable share of her retirement spending. She’s concerned about recent news that the Social Security retirement trust fund will run out in 2032 – just six years from now. Having read the headlines, she is now worried she’ll lose much of her retirement benefits. In truth, payroll taxes at that time will be enough to pay 78 percent of scheduled Social Security benefits. That means the worst case is that she’ll face a 22-percent reduction in benefits, something we could accommodate in her financial plan. But it shows how common misconceptions can cause us unnecessary stress and lead to such fear-based decisions as living well below…

I recently toured Opus, an inspiring new senior living development in Newton, Massachusetts, and then had a conversation with its founder, Amy Schectman, on my Risking Old Age in America podcast. Amy explained to me how she had helped develop both a high-end senior living development, NewBridge on the Charles, and lower-income senior housing, Brown Family Life. With Opus, she was seeking to create housing for the often-overlooked middle market. She said that she and her team worked through many challenges in making the economics work without the prices they could bring for the higher-end market nor the subsidies available for lower-income housing. She feels that they can repeat this prototype elsewhere. Excerpts from Our Conversation Risking Old Age in America (ROA): The peo…

One of the most fortunate events of my life was my first job after college at the Center for Retirement Research at Boston College (CRR). Not because of the salary — I think I earned less than $40K. What was fortuitous were the early lessons I learned about building toward a secure retirement. Those lessons boil down to two simple but critically important points I urge you to share with any new graduate: Simple, yes — but in a world of financial complexity, these two things do most of the heavy lifting toward long-term retirement planning. My first project at the CRR was building a game where a fictional character named Sally makes financial decisions at different ages — how…

Neal K. Shah, the founder of CareYaya, a company that links students in the healthcare field with seniors needing assistance, has some strong opinions about elder care in the United States. The word Yaya means ‘grandmother’ in Greek and ‘caregiver’ in Swahili and Thai. As an acronym, it also means ‘You Are Your Advocate.’…

I recently attended a financial advisor conference focused on artificial intelligence. Drawing on what I learned, this post summarizes my thoughts on how AI may reshape financial planning for retirement savers. Spoiler alert: I think it has great potential to help both advisors and individuals. The first iteration of AI tools has already improved retirement planning. For example, forward-thinking advisors are currently using AI note-taking tools, which allow advisors to listen more closely to their clients without missing any key details. A good AI tool will summarize the meeting, complete with a list of follow-up items. For DIY investors, chatbots like Claude or ChatGPT are useful tools for researching financial products, tax rules, and harder questions like when to claim…

One of the challenges of obtaining home health care for seniors is its cost, which is often beyond the means of people and their families. The cost barrier is especially true of aides hired through private home health agencies, which is often considerably more expensive than hiring an aide directly. On my Risking Old Age in America podcast, I recently talked with Wendy Adlerstein, co-owner of First Light Home Care in west suburban Boston, about the benefits of hiring assistance through an agency and what goes into the extra cost. She also calls for statewide licensure of home health agencies to make sure they all provide what they promise. Here are some extracts from our discussion: Risking Old Age in America…