In a decade, the leading edge baby boomers will enter their 80s, the age group most likely to need long-term services and supports (LTSS). However, the United States has no national long-term care policy or system. To accelerate systematic change, two philanthropic organizations and the largest membership organization for older people in the world (AARP) developed a unique multi-dimensional approach to measure LTSS performance from the perspective of consumers and their families. State systems in the United States are scored across five dimensions: (1) affordability and access, (2) choice of setting and provider, (3) quality of life and quality of care, (4) support for family caregivers, and (5) effective transitions across settings of care. This paper articulates six years of progress & trends in state LTSS reform, while identifying areas of ongoing, needed improvement.
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