AARP’s Long-Term Services and Supports State Scorecard 2023 Edition
By Susan Reinhard, Ari Houser, Carrie Amero, Paul Lingamfelter
The 2023 LTSS State Scorecard (the Scorecard) is a compilation of state data and analysis based on a new vision of a high-performing state long-term services and supports (LTSS) system. Released every three years, the Scorecard uses data from a wide range of sources to describe how state LTSS systems are performing. Our intention is to identify strengths and weaknesses in state systems to spark and inform the development of actionable solutions at the local, state, and national levels—solutions that respond in meaningful ways to individual preferences and family choices and care needs as well as to new pressures and challenges. The hope is that it will help everyone who is part of these state systems to take action that will transform and modernize them. This fifth edition of the Scorecard relies on indicators that have been tracked since the first Scorecard in 2011 to show trends over time. It also includes 20 new indicators and new ways of analyzing and displaying data to provide a more comprehensive picture of state performance. Revisions were made to the five dimensions of high performance and organized states into performance tiers. All of these improvements are intended to offer states the clearest information we can about their performance as they rebuild and reimagine their LTSS systems going forward.
As with previous Scorecards, states are ranked 1-51 relative to one another for each indicator, each dimension, and overall. While previous editions of the Scorecard have grouped states into equally sized quartiles, this edition groups states into performance tiers, to better reflect the natural distribution of state performance, where historically, most states fall closely together in the middle and very few states perform significantly above or below the national average. Only five states (Colorado, District of Columbia, Minnesota, Washington, Massachusetts) consistently scored high enough across all 50 indicators to reach the top tier of performance.
The Scorecard scores across five dimensions of LTSS, comprised of 50 indicators. The table below summarizes the 50 indicators into 5 groupings which are ranked. See the Massachusetts Scorecard for the rankings by individual indicators.
Ranking Topic, MA Rank, Top State
- Overall, Across Five Dimensions of LTSS, 4, Minnesota
- Affordability and Access, 4, District of Columbia
- Choice of Setting and Provider, 2, California
- Safety and Quality, 14, Hawaii
- Support for Family Caregivers, 13, Minnesota
- Community Integration, 9, District of Columbia