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Long Term Services and Supports Scorecard

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This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that provide assistance to older people and adults with disabilities. Performance varies tremendously across the states with LTSS systems in leading states having markedly different characteristics than those in lagging states.


The Scorecard examines state performance across four key dimensions of LTSS system performance: (1) affordability and access; (2) choice of setting and provider; (3) quality of life and quality of care; and (4) support for family caregivers. It is designed to help states improve the performance of their LTSS systems. It also underscores the need for states to develop better measures of performance over a broader range of services and collect data to more comprehensively assess the adequacy of their LTSS systems.

In general, the states at the very highest levels of performance have enacted public policies designed to:
  • improve access to needed services and choice in their delivery by transforming their Medicaid programs to cover more of the population in need and offer the alternatives to nursing homes that most people prefer;
  • facilitate access to information and services by developing effective “single point of entry” systems so that people who need services can find help easily; and
  • address the needs of family caregivers by offering legal protections as well as the support and services that can help prevent burnout. 

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