States See Progress in Long-Term Care, But Still Can Improve

With both health care costs and the age of the U.S. population rising, states are caught between the needs of elder care and the necessity of restraining spending.

The SCAN Foundation’s Pacesetter Prize, created this year, is aimed at recognizing the states that have risen to the challenge by improving long-term services and support (LTSS) for family caregivers, older adults and people with disabilities. It drew on data from the AARP LTSS State Scorecard, which ranks states’ performance on measures that include affordability and access, provider and setting choice, quality of life and care, support for family caregivers and effective transitions.

The winners, which were announced November 15, were:

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—Vermont for improving affordability and access

—Wisconsin for improving choice of setting and provider

—Minnesota for improving support for family caregivers

—New York for improving effective transitions

Kari Benson, executive director of the Minnesota Board on Aging and director of the Minnesota Department of Human Services Aging and Adult Services Division, and Mark Kissinger, special advisor to the Commissioner of Health—New York State Department of Health, spoke about how their states were able to lead the way on a Thursday webinar.

Sticker shock

Benson emphasized the need for any long-term care system to support the whole family, and Kissinger broadened it to include those receiving the care and the range of partners in the overall health care system.

The cost of paid services in the long-term field was a particular point of note. Costs are high and often paid out of pocket, panel moderator Gretchen Alkema  of the SCAN Foundation noted. People pay the most for such services, with Medicaid a close second, she added.

“People are very surprised by the cost of long-term care because they don’t really think about it until they actually have to,” Kissinger said in the webinar.

In Minnesota, counseling for caregivers makes sure to integrate financial information, “so they’re tapping into the programs and resources that make the most sense for them,” Benson said.

Building blocks

Many components go into building a high-quality system of long-term care services and supports, and Kissinger stressed the need to examine rankings such as the state scorecard and go deeply into the details. It paid off for New York, which went from being ranked 45th of the 50 states for effective transitions in 2014 to 32nd in 2017. But the state still could stand to make progress, Kissinger stressed.

“One of the biggest issues we’re facing in New York…is workforce,” he added.

Using these metrics to drive better quality is a key area for improvement in Minnesota, Benson said. There is a particular need for this in the home and community-based services arena, she added.

“We have a long ways to go in terms of having the capacity for that measurement, and frankly being able to make the case to our funders that it’s a good investment to make,” she said.

Written by Maggie Flynn

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