With baby boomers beginning to turn 80 in 2026, states must accelerate the pace of improving long-term services and supports (LTSS) for older people and adults with disabilities, according to AARP’s new state scorecard released in June.
The report, Picking Up The Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (Scorecard), shows that although most states have made some progress, the pace of change overall remains too slow and has not kept up with demographic demands.
LTSS includes assistance with activities of daily living provided to older adults and people with disabilities who cannot perform these activities on their own because of physical, cognitive, or chronic health conditions. The types of assistance include such things as help with bathing, dressing, managing medications, preparing meals, and transportation, as well as support for family caregivers.
“This Scorecard sounds the alarm, but it also provides a range of tools states can use to spark new solutions and create systems that are aligned with the new realities of aging and living with a disability,” said Susan Reinhard, RN, Ph.D. and senior vice president and director of the AARP Public Policy Institute. “The proposed cuts to Medicaid—the largest public payer of long-term assistance—would result in millions of older adults and people with disabilities losing lifesaving supports.”
The Scorecard was funded by AARP Foundation, the Commonwealth Fund and the SCAN Foundation. It is the third edition of the Scorecard.
Officials said the Scorecard ranks states based on their performance on LTSS in five main categories: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions between nursing homes, hospitals and homes
Within the five categories, states are scored on their performance in 25 specific indicators, including such things as Medicaid spending, nursing home cost, home health aide supply, antipsychotic medication use in nursing home residents, long nursing home stays, employment rate of people with disabilities, and support of working caregivers.
“This new Scorecard shows that it’s time for all states to accelerate care improvements for older adults and people with disabilities,” said Dr. Bruce Chernof, FACP, president and CEO of the SCAN Foundation. “States that consistently rank at the top have strategically planned for their aging population across the main sectors of health, housing, transportation and family caregiving.”