Advancing Action, 2020: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers

The Vision

September 24, 2020

By definition, a vision is aspirational. Guided by the Scorecard National Advisory Panel, our vision of LTSS system performance is composed of five characteristics that are approximated in the Scorecard by dimensions for which LTSS performance can be measured where data are available. Each dimension is constructed from individual indicators that are interpretable and show variation across states (see Exhibit 1). Achieving this vision takes concerted action, as well as data to measure the extent to which states reach the vision.

  1. Affordability and Access
    Consumers are able to easily find, pay for, and receive the services they need in the setting they choose. Medicaid public safety nets are sufficient to provide peace of mind and security to those who cannot afford services.
  2. Choice of Setting and Provider
    Consumers are at the center of care and have the choice of setting and control over their services and who provides them.
  3. Quality of Life and Quality of Care
    Consumers are treated with dignity and respect. Their personal preferences and aspirations are honored whenever possible. The services they receive are effective and quality is measured and compared both within and across states for continuous improvement.
  4. Support for Family Caregivers
    Family caregivers are recognized as the backbone of the LTSS system. Caregivers’ own needs are identified and supported.
  5. Effective Transitions
    Consumers experience seamless coordination across LTSS and health care systems with minimal disruption and unnecessary hospitalizations.


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