Current Awareness in Aging Research (CAAR) Report #541 -- June 17, 2010

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:

1. ADMINISTRATION ON AGING: AoA has updated it's AGing Integrated Database (AGID) to include data from the "National Participants Survey (NPS) 2009."

To access the databases go to:


II. Reports and articles:

2. US DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF THE INSPECTOR GENERAL REPORT: "Medicare Part D - Prescription Drug Event Reconciliation Process" (A-18-08-30102, June 2010, .pdf format, 38p.).


We contracted with a certified public accounting firm to audit CMS's Medicare Part D Prescription Drug Event (PDE) reconciliation process. CMS's reconciliation process compares estimated subsidy payments made to plan sponsors throughout the year with the cost data submitted by plan sponsors through PDE records and direct or indirect remuneration (DIR) data to determine any residual payments required by CMS to plan sponsors or plan sponsors to CMS.

The audit focused on understanding the design and effectiveness of CMS's controls to (1) accurately calculate and track monthly plan sponsor payments, (2) identify incomplete and/or inaccurate PDE records received, and (3) determine the completeness of PDE records before year end reconciliation to determine risk-sharing amounts and adjustments to risk corridors.

The audit recommended that CMS (1) strengthen controls over the bid review and audit process, (2) improve controls over the accuracy and completeness of PDE and true out-of-pocket accumulation, (3) strengthen controls to ensure completeness and accuracy of DIR data before reconciliation, and (4) conduct more plan sponsor audit procedures throughout the benefit year. CMS generally agreed with the recommendations.


3. US GOVERNMENT ACCOUNTABILITY OFFICE REPORT: "Home Infusion Therapy: Differences between Medicare and Private Insurers' Coverage" (June 2010, HTML and .pdf format, 31p.). Links to an abstract and full text are available at:


4. US SOCIAL SECURITY ADMINISTRATION, OFFICE OF RETIREMENT AND DISABILITY POLICY REPORT: "International Update, June 2010" (June 2010, HTML and .pdf format, 3p.).


5. US ADMINISTRATION ON AGING REPORT: "Toolkit for Serving Diverse Communities" (2010, .pdf format, 129p.).


6. US DEPARTMENT OF HEALTH AND HUMAN SERVICES NEWS RELEASE: "HHS Secretary Sebelius Urges Vermont Governor Douglas to Maintain Current Benefits for Vermont's Seniors" (Jun. 11, 2010).


7. US NATIONAL INSTITUTES OF HEALTH NEWS RELEASE: "Gene Linked to Alzheimer's Disease Plays Key Role in Cell Survival" (Jun. 10, 2010).


8. STANDING SENATE COMMITTEE ON BANKING TRADE AND COMMERCE [CANADIAN PARLIAMENT] REPORT: "Canadians Saving for their Future: A Secure Retirement," (May 2010, .pdf format, 43p.).


9. EUROPEAN COMMISSION PERIODICAL ARTICLE: "Highly educated men and women likely to live longer," by Veronica Corsini (in Statistics in Focus, 24/2010, .pdf format, 3p.).


10. PENSIONS INSTITUTE [UK] REPORT: "Saving Britain: A White Paper on Rebuilding Britain's Savings Culture," (June 2010, .pdf format, 15p.).


11. INTERNATIONAL LONGEVITY CENTRE [UK] REPORT: "The Future of Retirement," by Craig Berry (June 2010, .pdf format, 27p.).



A. "Social Media and Technology Use Among Adults 50+," by Jean Koppen (June 2010, .pdf format, 13p.).

B. "Automatic 401(k) Plans: Employer Views on Enrolling New and Existing Employees," by S. Kathi Brown (June 2010, .pdf format, 72p.).

C. "Recession Takes Toll on Hispanics 45+: Boomers Particularly Hard Hit," by Rebecca Perron (March 2010, .pdf format, 53p.).

D. "Preventive Health Screenings Among Midlife and Older Adults," by Teresa A. Keenan (February 2010, .pdf format, 27p.).


13. INVESTOR PROTECTION TRUST REPORT: "Elder Investment Fraud and Financial: Exploitation A Survey Conducted for Investor Protection Trust," (June 2010, .pdf format, 51p.).

More about the Trust:


14. NATIONAL CENTER ON SENIOR TRANSPORTATION REPORT: "Transportation: The Silent Need," (June 2010, .pdf format, 24p.).


15. NATIONAL SENIOR CITIZENS' LAW CENTER WEBINAR: "The National Senior Citizens' Law Center presents a webinar on Health Care Reform and the Aging Population."

With the enactment of the Patient Protection and Affordable Care Act (PPACA), health care reform finally became a reality. This historic legislation will impact virtually every facet of the nation's healthcare system, including the programs and services on which low-income older individuals rely.

This webinar will present an overview of how the PPACA will affect older individuals, with a focus on the Medicaid long-term services and supports provisions, the provisions relating to long-term care facilities, and the changes that will have a particular impact on dual eligibles, such as certain changes to Medicare Part D and Medicare Advantage.

The presenters will be Eric Carlson, Gene Coffey, and Georgia Burke, all of whom are attorneys with the National Senior Citizens Law Center.

Sponsorship for this Webinar is provided by the National Consumer Law Center and the National Senior Citizens Law Center. This webinar is in a series of National Elder Rights Training Project webinars for the National Legal Resource Center. The Administration on Aging supports the resource center through grant funding.

Title: Health Care Reform and the Aging Population: How the Patient Protection & Affordable Care Act will impact low-income older adults"

Date: Wednesday, June 23, 2010

Time: 2:00 PM - 3:30 PM EDT

Space is limited.

Reserve your Webinar seat now at:



A. "Polymorphisms in the Mitochondrial DNA Control Region and Frailty in Older Adults," by Ann Z. Moore, Mary L. Biggs, Amy Matteini, Ashley O'Connor, Sarah McGuire, Brock A. Beamer, M. Danielle Fallin, Linda P. Fried, Jeremy Walston, Aravinda Chakravarti, and Dan E. Arking (PLoS ONE 5(6): e11069. doi:10.1371/journal.pone.0011069, XML, HTML, and .pdf format, 6p.).

B. "Neuronal MicroRNA Deregulation in Response to Alzheimer's Disease Amyloid-{beta}," by Nicole Schonrock, Yazi D. Ke, David Humphreys, Matthias Staufenbiel, Lars M. Ittner, Thomas Preiss, and Jurgen Gotz (PLoS ONE 5(6): e11070. doi:10.1371/journal.pone.0011070, XML, HTML, and .pdf format, 11p.).

C. "Regulation of Amyloid Precursor Protein Processing by the Beclin 1 Complex," by Philipp A. Jaeger, Fiona Pickford, Chung-Huan Sun, Kurt M. Lucin, Eliezer Masliah, and Tony Wyss-Coray ( PLoS ONE 5(6): e11102. doi:10.1371/journal.pone.0011102, XML, HTML, and .pdf format, 15p.).

D. "How Are the Interests of Incapacitated Research Participants Protected through Legislation? An Italian Study on Legal Agency for Dementia Patients," by Sabina Gainotti, Susanna Fusari Imperatori, Stefania Spila-Alegiani, Laura Maggiore, Francesca Galeotti, Nicola Vanacore, Carlo Petrini, Roberto Raschetti, Claudio Mariani, and Francesca Clerici (PLoS ONE 5(6): e11150. doi:10.1371/journal.pone.0011150, XML, HTML, and .pdf format, 10p.).


17. BRITISH MEDICAL JOURNAL NEWS EXTRACT: "Number of "oldest old" has doubled in the past 25 years," by Jacqui Wise (BMJ 2010;340:c3057).


III. Working Papers:

18. UNIVERSITY OF MICHIGAN RETIREMENT RESEARCH CENTER: "How Common is "Parking" Among Social Security Disability Insurance (SSDI) Beneficiaries? Evidence from the 1999 Change in the Level of Substantial Gainful Activity (SGA)," by Jody Schimmel, David Stapleton and Jae Song (WP 2009-220, June 2010, .pdf format, 43p.). Note: Links to the abstract and full-text can be found at:



A. "Recessions, Reeling Markets, and Retiree Well-Being," by Courtney C. Coile and Phillip B. Levine (w16066, June 2010, .pdf format, 40p.).


This paper examines the impact of late-career investment returns and job loss on subsequent retiree well-being. Specifically, we explore whether there is a link between the income of retirees aged 70 to 79 and the stock market and labor market conditions that existed around the time of their retirement. We use data from the 2000 Census and the 2001 through 2007 American Community Surveys and consider both total personal income and income by type. We find that a long-term decline in the stock market in the years leading up to retirement leads to a modest reduction in investment income a decade or so later for those in the top third of the income distribution. The consequences of approaching retirement when the labor market is weak are more severe. A higher unemployment rate around the time of retirement reduces Social Security income for those in the bottom two-thirds of the income distribution; we estimate that an unemployed worker experiences a roughly 20 percent drop in Social Security income, consistent with claiming benefits several years early. Overall, our results indicate the importance of the challenges faced by lower-income workers who face a weak labor market as they approach retirement.

B. "Income and the Utilization of Long-Term Care Services: Evidence from the Social Security Benefit Notch," by Gopi Shah Goda, Ezra Golberstein, and David C. Grabowski (w16076, June 2010, .pdf format, 35p.).


This paper estimates the impact of income on the long-term care utilization of elderly Americans using a natural experiment that led otherwise similar retirees to receive significantly different Social Security payments based on their year of birth. Using data from 1993 and 1995 waves of the AHEAD, we estimate instrumental variables models and find that a positive permanent income shock lowers nursing home use but increases the utilization of paid home care services. We find some suggestive evidence that the effects are due to substitution of home care for nursing home utilization. The magnitude of these estimates suggests that moderate reductions in post-retirement income would significantly alter long-term utilization patterns among elderly individuals.



A. "Issues in the Issuance of Enhanced Annuities," by Robert L. Brown and Patricia Scahill (Working Paper No. 265, May 2010, .pdf format, 18p.).


Two forces are about to create a growing market for Individual Annuities in the U. S. and Canada. First, the Post War Baby Boom (born 1946 to 1964) is inexorably moving into retirement. Second, there is a strong move away from Employer-sponsored Defined Benefit pension plans to Defined Contribution pension plans. This trend could even extend (in the U.S.) into the provision of Social Security benefits.

Under these arrangements, participants must find a way to mitigate their "longevity" risk (and the investment risk, although this is not the topic of this paper). The most obvious answer is to buy a life annuity. However, at this time in the U. S. and Canada, persons who voluntarily apply to buy a life annuity are generally assumed to be in extremely good health and annuity rates are determined using very low mortality assumptions (high life expectancy assumptions). While there is a growing market in "Enhanced/Impaired Annuities", especially in the U.K., the present pricing structure for annuities in the U. S. and Canada means that a large proportion of the population cannot get a "fair value" annuity given their less-than-preferred health profile.

This paper looks at reasons for this market reality in the U. S. and Canada. It also reviews the underwriting and marketing of life annuities in the United Kingdom where "enhanced" life annuities are available for a broader cross-section of the marketplace.

B. "Criteria for the Optimal Design of a Social Security Retirement System," by Robert L. Brown (Working Paper No. 266, May 2010, .pdf format, 20p.).


This paper discusses a series of selection points in the design and financing of social security retirement systems. For each criterion, the paper lists and discusses advantages and disadvantages of the options available.

The selection points include:

- Funded versus PAYGO
- Minimum benefits: Demogrant or Welfare
- Progressive versus Regressive
- Voluntary versus Mandatory
- Individual Accounts versus Commingling of Risk
- Public versus Private sourcing
- Automatic Balancing Mechanisms
- System Risk Diversification

It is the sincere hope of the author that this discussion will create even more debate of the issues surrounding these important selection criteria which, in turn, will result in better social security retirement systems for all.

C. "Retirement 20/20: Innovation in Pension Design," by Robert L. Brown (Working Paper No. 267, May 2010, .pdf format, 24p.).


Today, both the United States and Canada are experiencing a decline in Single-Employer Sponsored Defined Benefit (DB) Pension plans. In some instances, they are being replaced by Defined Contribution (DC) or Individual Account [e.g., 401(k)] plans; in other cases, by nothing.

It appears that traditional sponsors of DB plans have concluded that their cost (or its variability) is larger than the rewards (e.g., a loyal work force). At the same time, two stock market meltdowns in less than a decade have indicated to all the frailties of Individual Account DC systems.

What we need is a new pension system that brings most of the advantages of the DB and DC plans to the participants, while minimizing their disadvantages. We must also recognize the skill set of the participants (e.g., do not expect a blue collar worker to be an investment professional) and not anticipate or require anomalous markets (e.g., ever-stronger equity returns).

Size matters. Larger plans can run at lower per unit expense ratios, and can also achieve entry into a wide variety of investment products (e.g., private placements) not available to a small plan. Larger funds also benefit from risk sharing through "Law of Large Numbers".

The model proposed is a "Jointly Governed Target Benefit Pension plan". Such plans would have many features in common with today's Ontario Multi-Employer Pension Plans (MEPPs), the Canada/Quebec Pension Plans (C/QPP), TIAA-CREF in the United States and the Dutch national plan. For the plan sponsor, this is a DC plan. Inherent in the concept are that smaller plans (and even individual plans) could commingle their assets to achieve "size" (e.g. a minimum investment portfolio of $10B). Investment management would be at arm's length from the plan itself.

D. "Economic Security in an Aging Canadian Population," by Robert L. Brown (Working Paper No. 268, May 2010, .pdf format, 41p.).


This paper has been written for the special issue of the Canadian Journal on Aging on the retrospective on the Butterworths series of monographs in social gerontology. The paper brings up-to-date materials published in 1991 in the volume entitled: Economic Security in an Aging Population.

The topics covered are those of the individual chapters of the 1991 publication, namely:

- Demographic Background
- Income and Expenditure Patterns of the Elderly in Canada
- Government-Sponsored Income Security
- Employer-Sponsored Pension Plans
- Individual Savings/Registered Retirement Savings Plans
- Economic Security Aspects of Health Care
- Future Funding of Social Security


21. NEP-AGE: Working papers in the Economics of Aging are available through the bibliographic database provided by Research Papers in Economics (RePEc). The latest compilation is for June 4, 2010.


IV. Journal Tables of Contents (check your library for availability):

22. Age and Ageing (Vol. 39, No. 4, July 2010).

23. Ageing and Society (Vol. 30, No. 5, July 2010).

24. American Journal of Alzheimer's Disease and Other Dementias (Vol. 25, No. 4, June 2010).

25. Journal of Aging, Humanities, and the Arts (Vol. 4, No. 2, 2010).

26. Journal of Aging and Physical Activity (Vol. 18, No. 3, July 2010).


27. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of June 14, 2010:

B. Alzheimer's Disease: Literature for the week of June 14, 2010:

C. Parkinson's Disease: Literature for the week of June 14, 2010:

D. Prostate Cancer: Literature for the week of June 14, 2010:

E. Stem Cell Research: Literature for the week of June 14, 2010:

F. Ophthalmology: Literature for the week of June 14, 2010:

AMEDEO Literature Guide:


V. Employment/Funding Opportunities:

28. US NATIONAL INSTITUTE ON AGING: "Health Scientist Administrator (Economics)," (Position numbers: NIA-10-411225-CR-DE (public) & NIA-10-411225- MP (merit promotion)). The position is open until June 25, 2010. For more information on the position go to the USA Jobs site:

Do a search with one of the position numbers as a "Keyword".


VI. Conferences:

29. US CENTERS FOR DISEASE CONTROL: "2010 National Conference on Health Statistics," to be held Aug. 16-18, 2010 in Washington, DC. For more information see:


30. CENTER FOR RETIREMENT RESEARCH AT BOSTON COLLEGE: "Retirement, Planning, and Social Security in Interesting Times," (to be held August 5-6, 2010, Washington DC). Pre-registration is recommended.

To pre-register go to:


31. CONFERENCEALERTS.COM PALLIATIVE CARE CONFERENCES: " ARC 2010 National Reiki Conference," To Be Held In Melbourne, Australia Oct. 9, 2010.

Conferencealerts.Com Palliative Care:


VII. Legislation Information Updates:

32. US SENATE SPECIAL COMMITTEE ON AGING HEARING TESTIMONY: "The Retirement Challenge: Making Savings Last a Lifetime," a hearing held June 16, 2010 (statements in .pdf format, full hearing can be viewed in Flash format).


33. US HOUSE WAYS AND MEANS COMMITTEE HEARING TESTIMONY: "Hearing on Reducing Fraud, Waste and Abuse in Medicare," held Jun. 15, 2010 (.pdf format). A video transcript of the hearing may also be available.




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