Produced every three years, this scorecard ranks states and the Distrcit of Columbia from 1 to 51 on a wide range of issues pertaining to older adults and people with disabilities.  The LTSS scorecard has five domains that states are ranked within, and each of those domains has multiple indicators that are used to derive the overall score.  The domains include:

• Affordability and Access

• Choice of Setting and Provider

• Quality of Life and Quality of Care

• Support for Family Caregivers

• Effective Transitions

AARP and ADvancing States recognize that the report can be challenging when solely viewed as a numerical ranking; however, it also can provide states with opportunities to highlight areas of success while simultaneously identifying areas for improvement. ADvancing States believes that all states have unique attributes and strengths and we are encouraged with the progress all states have made since AARP initiated this project in 2011.  ADvancing States encourages each state to look beyond the total tabulations and state rankings and spend time understanding the individual components within each of the domains and how your state may improve as well as areas of success that you can highlight.  

A few important things to consider about this report:

Some of the factors that impact the indicators are within Aging and Disability or Medicaid agencies’ spheres of influence, but many are not.  (i.e. the poverty rate in your state, Medicare policy, housing affordability, and Federal funding allocations for several programs)

Some of the data-sources used, including those from the Federal government, (especially CMS) may not be current enough to reflect improvements made in state systems since the information was first collected. 

Many state-specific innovations may also not be captured because the report relies on sources of data that can draw all-state comparisons. 

Many of the indicators and data sources shifted since the most recent release of the scorecard, so we do not believe it is useful to compare results across the different reports; however, we caution that there is likely to be press attention paid both to the individual state rankings as well as to any change in positioning that occurred between the releases. 

The ranking of the top five states is as follows (note: some states are tied in this ranking system) 

1. Minnesota

2. Washington

3. District of Columbia

4. Massachusetts

5. Colorado

Vermont’s change in ranking from #5 in the 2020 report to #9 in the 2023 report is primarily due to performance in affordability of long-term care as compared to other states.

A wide variety of public and private entitities contribite to each state's ranking including:

• the federal government
• state government
• local government
• HCBS service providers
• LTSS facilities
• Housing agencies and providers
• Transportation agencies and providers

Updated September 2024.

2023 Report: Scorecard Report | Long-Term Services and Supports State Scorecard (aarp.org)

Data source:  national reports (as of December 2022):

http://www.longtermscorecard.org/~/media/Microsite/Files/2020/LTSS%202020%20Short%20Report%20PDF%20923.pdf

http://www.longtermscorecard.org/2017-scorecard

http://www.longtermscorecard.org/2014-scorecard

http://www.longtermscorecard.org/2011-scorecard