How the Affordable Care Act Can Help Move States Toward a High-Performing System of Long-Term Services and Supports

States are moving from a system that emphasizes institutional care to a broader range of long-term services and supports (LTSS) for people who—because of ongoing disabilities and chronic conditions—require long-term assistance, delivered in settings that range from private residences to assisted living facilities and nursing homes.

The Affordable Care Act of 2010 offers states timely new options and enhanced federal funding to create a care system that meets the diverse needs and preferences of people with disabilities and that also recognizes the role of family caregivers.

To help states assess their care systems and take advantage of opportunities offered by health reform, this article defines LTSS and articulates what a high-performing system of delivering them would look like. These two steps lay the foundation for developing a performance “scorecard” for a state-level system of LTSS. Once this tool is available, it will permit comparisons among states at a given point in time and will make it possible to measure progress in an individual state over time.  The team expects to release its final report and the scorecard in the summer of 2011.

AARP, the Commonwealth Fund, and the SCAN Foundation sponsored the research for this article.

This article was published in Health Affairs.