1. Introduction

Due to the different models and concepts of long-term care insurance systems in different countries, scholars at home and abroad hold different views on the concept of long-term care. However, the views of American scholars Rosalie A. Kane and Robert L. Kane are generally recognized by scholars around the world, i.e., long-term care refers to the long-term provision of personal care, basic medical services and social services for people who have lost or do not have the functions of daily living ^[1]. Long-term care services include low-level care services to support daily living, such as eating, dressing, bathing, toileting, and transportation, as well as some basic medical services, such as wound dressing, pain management, monitoring, prevention, rehabilitation, and palliative care and nursing ^[2]. Long-term care insurance (LTCI) is a form of social insurance that spreads the economic risk of people who need long-term care services. Specifically, long-term care insurance refers to a social insurance system in which insurers entrust organizations or individuals to provide, in accordance with the law, daily living care, basic medical services and social services to insured individuals who have lost or are unable to carry out activities of daily living and who are enrolled in long-term care, basic medical services and social services.

According to the logical dimension of "the social security system consists of the basic constituent elements of identification of the insured, public service, financing, fund management and supervision, benefit payment and settlement payment", the main contents of the long-term care insurance system are analyzed as follows: 1. Participants Participants are individuals who are obliged by law to pay long-term care insurance premiums and enjoy the right to apply for insurance benefits when the need for long-term care services arises, also known as those included in the long-term care insurance coverage. Participants are individuals who are obligated by law to pay long-term care insurance premiums and are entitled to apply for insurance benefits when the need for long-term care services arises, and are also referred to as persons covered by long-term care insurance. Long-term care insurance organization The long-term care insurance organization is the insurer of long-term care insurance, and its main responsibilities include: firstly, it is responsible for the registration of participants, financial management of the fund, declaration and acceptance, approval of treatment, approval of expenses, settlement and payment, and construction and maintenance of the information system; secondly, it is responsible for guiding the development of long-term care service organizations through bidding or entrusting the purchase of long-term care services. The financing system for mobilizing funds for long-term care insurance includes financing sources, financing levels and financing methods. The financing of social insurance comes from the mutual assistance and sharing of the whole society by multiple subjects. From the perspective of long-term care insurance financing in China's current pilot program, the main sources of multiple financing are: transfer of the balance of the comprehensive medical insurance fund, transfer of funds from individual accounts of medical insurance, individual or unit contributions, financial subsidies, welfare lottery public welfare funds, etc. Basically, according to the pilot program in each region, two or more sources of financing are chosen. Financing methods include quota financing, proportional financing and mixed financing. Flat-rate financing refers to the payment of an exact amount of participation fee for a specific period of time. Proportionate financing refers to the proportional contribution of the insured, including the basis and rate of contribution. Hybrid financing is the use of both fixed and proportional financing. The level of financing depends on the level of economic development, the degree of aging, and the scope and level of protection.

2. Benefit Payment

The design of a long-term care insurance treatment payment system consists of two components: identification of care needs and payment for insured treatment. (1) Determination of Need for CareThe identification of need for care is the legal act by which an insurer determines, based on an application for care by an insured person or another person, whether an insured person has a need for care and what level and degree of care he or she should receive, in accordance with the provisions of the Long-Term Care Act. The states generally provide for an independent, specialized third party to make a valid determination based on statutory criteria. Determining the need for care is a statutory prerequisite to whether an insured person can receive care and to what extent and standard of care d. (2) Benefit Treatment Payment for long-term care insurance is the process of determining the scope and content of treatment payments by paying the insured person according to certain standards, forms, and methods of payment for treatment. The forms of treatment payment generally include service payment, cash payment and hybrid payment. Payment for services are services commissioned by the insurance agency to be provided by the service provider in accordance with the needs of the cared-for person, including housework, assistive devices, home delivery of meals, accessibility modifications, emergency calls, and so on. Cash payments are made by the insurance agency directly to the cared-for person and are paid in cash. Cash benefits are cash compensation provided by the insurance agency directly to the person being cared for. The person being cared for can choose the care services according to his/her needs, or the services can be provided by his/her relatives, and the cash benefits will be used as compensation to the relatives. These include both fixed-amount benefits and benefits that actually occur. Hybrid payments are a combination of payments for services and cash payments. Payment options include fixed and limited payments. Fixed rate payments are paid at a fixed rate. Limited payments are paid from the Long-Term Care Insurance Fund up to a maximum. Costs include bed charges, nursing service charges, nursing equipment use charges, nursing supplies, appraisal and assessment charges, treatment charges and medicine charges. The payment standard is the criterion for the proportion of nursing costs to be paid by the Fund. Different classification criteria are used in different pilot regions, including determining the proportion of contributions for institutional care and home care based on the form of care; determining the proportion of contributions for employees and urban and rural residents based on the scope of coverage; determining the proportion of payment based on the degree of incapacity; and determining the proportion of payment based on the level of the care facility. These payment rates determine different coverage.

3. Care Service Providers

Care service providers are divided into home care service providers, community care service providers, and institutional care service providers. Home-based care is a care model that combines informal care provided by family members and specialized care provided by individual service providers or professional organizations for persons with disabilities who live at home, as opposed to traditional family care. Community care is between family care and institutional care, and groups of persons with disabilities do not need to leave the community in which they live; the community is the main provider of care services, taking on responsibility for living care, medical rehabilitation and nursing care. The community is the main body of care services, taking care of life care, medical rehabilitation and nursing care. Institutional care is a model of care in which older persons receive specialized, integrated services in socialized institutions. Institutional care services are necessary only when home care services and community care services are unable to meet the needs of the person in need of care. Institutional care service providers need to be qualified and capable of providing care services, and all types of medical institutions, elderly care institutions and nursing institutions can be care service providers. Institutional care service providers implement an agreement management system, and the agreement includes the scope of service, service content, settlement method, management assessment, liability for breach of contract, etc.

4. Management and Supervision

The supervision and management of long-term care insurance includes fund supervision and management, service supervision and management, and management and management and information system. Fund supervision and management includes the operation and supervision of the long-term care insurance fund, generally in accordance with the current social insurance fund system. Supervision and administration of services includes agreement management and supervision and auditing of service organizations and practitioners, which should be legally qualified and in accordance with the management regulations of the relevant departments, and practitioners should have appropriate qualifications and service capabilities. The supervision and management of management includes management procedures, service standards, agreement management and supervision and inspection of management organizations. Supervision and management of information systems relies on the application of "Internet plus" and other innovative technologies to build and supervise the long-term care insurance system platform.