A new state-by-state scorecard evaluates the effectiveness of long-term care services across the country and concludes that there is a lot of room for improvement. The State Long-Term Services and Supports Scorecard examines the performance of state long-term care services for older people and adults with physical disabilities. The purpose of the report is to provide information on how to improve long-term care systems so that everyone can have affordable, high-quality, well-coordinated services, and family caregivers have the support they need.

The scorecard, a collaboration between the AARP, The Commonwealth Fund, and The SCAN Foundation, looked at the range of services and supports available for people who need long-term care, whether in their home, nursing home, assisted living facility, or other setting. The report ranked the performance of long-term care systems in states in four main categories: affordability and access, choice of setting and provider, quality of life and quality of care, and support for family caregivers. According to the report, Minnesota, Washington, and Oregon provided the best long-term services and Mississippi, Alabama, and West Virginia provided the worst.

The findings indicate that there is a lot of area for improvement even in the top-performing states, and the report presents several actions that states can take to improve performance. One recommendation is that states expand Medicaid eligibility to increase access and choice as well as move the balance of services away from institutional care and toward home or community-based options. Other recommendations include providing greater flexibility to consumers to direct their own services, helping to move nursing home residents who want to return to the community back to their homes, and making sure nursing homes are properly and frequently monitored.

All the information from the scorecard has been put into an interactive Web site (http://www.longtermscorecard.org/) to allow policymakers to identify areas where improvement is needed and uncover gaps within the system.

To read the report and see a breakdown by state, go to http://www.longtermscorecard.org/.