Good, Bad, Blah

The groups that produced the scorecard want states, patient advocacy groups and others to push for improvements.

“Leading states do well in multiple dimensions, but all have far to go,” Chernoff said at the ILTCI Conference.

States’ performance on the indicators varied widely, and no state ranked in the top quarter in terms of all 25 indicators used to produce the scores, Chernoff said.

Alaska, for example, ranked 17th overall, and it ranked in the top quarter in terms of choice of setting and provider and in terms of quality of life and quality of care. But the state ranked in the bottom quarter in terms of  support for family caregivers and the cost of care. Compilers of nursing home cost survey reports usually find that Alaska has the most expensive nursing homes in the country.

One way states could improve their scores would be to spend more Medicaid LTC money on home care, rather than institutional care, and to make sure that a higher percentage of patients who end up in institutions start out seeing if they can get by at home, Chernoff said.

For producers, the message of the map may be that, whatever states and policymakers do in the future, consumers in the bottom-ranking states desperately need LTCI and comprehensive LTC plans today.

Some ideas for how LTCI producers might use the scorecard data in marketing and community relations efforts:

1. Click the “embed” button on the LTC scorecard Web page, at http://www.longtermscorecard.org/, to get the HTML code you need to share the map with consumers.

2. Organize and participate in panel discussions that focus on what the score says about the state of LTC services in your state.

3. Use the information about weaknesses in LTC services in your state to drive home the message that simply depending on Medicaid, the kids and fate to provide the right care at the right time may be a high-risk approach.