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Reimagining the State LTSS Scorecard: Invitation to Chart a Path Forward

The COVID-19 pandemic exposed both new and longstanding cracks in the long-term services and supports (LTSS) system—cracks that have serious implications for consumers in need of LTSS and their family caregivers. It is time to reimagine, redesign, and rebuild both LTSS systems and the ways we measure their performance.

For the past decade, the Long-Term Services and Supports State Scorecard has been the premier tool to measure performance within and across states. Produced by the AARP Public Policy Institute with support from The SCAN Foundation, The Commonwealth Fund, and AARP Foundation, the Scorecard has empowered state and federal policymakers to assess state LTSS system performance across multiple dimensions and indicators. It offers a way to assess how we, as a nation, are performing as we strive to improve the lives of older adults, adults with disabilities, and their family caregivers.

There is both an opportunity and an imperative to redesign the next Scorecard. This tool has the potential to draw further attention to critical issues in LTSS exposed by the COVID-19 crisis and help states build and maintain momentum in their efforts to modernize their LTSS systems.

At this critical juncture, therefore, the Scorecard team is reaching out to many LTSS stakeholders across the country to find ways to better measure state progress toward a truly high-performing LTSS system. We invite you to join us.

Following are some of the major questions and considerations of focus:

  • What is necessary for LTSS? What are the necessary elements of a high-performing LTSS system? Does our existing framework for a high-performing LTSS system (pictured in Exhibit 1 below) include all of the most important components? Is there anything that should be added or removed?
  • What about COVID-19? How should the next Scorecard address and reflect the impact of COVID-19? How could we measure the effectiveness of state responses to the pandemic? 
  • How can we include more voices?  Could the Scorecard be more helpful for audiences other than advocates and policymakers? Are there organizations, stakeholder groups, or individual influencers we should collaborate with to do more in putting people first?
  • Which information is most useful? Would it be helpful to provide, in addition to the state rankings, more context for how states are doing compared to each other and compared to a high-performing LTSS system? How should indicators that show most states to be tied, or with only small differences in scores, be presented to reveal relative performance?

If you have suggestions for how to best measure state LTSS system performance, we would welcome your input by email.  As we begin gathering information, we are hearing we need to consider workforce issues, disparities in access to services and in quality of services, effective use of the additional federal funding that has been made available to states for LTSS investments, increased family caregiver support, and more. 

If you have anything to share, please take a moment to email your ideas or suggestions to the Scorecard team at

Thank you for your support.   

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