skip to Main Content


caregiver and senior woman riding wheelchair

AARP Releases 2023 LTSS State Scorecard

AARP recently released its 2023 Long Term Services and Supports (LTSS) Scorecard. The Scorecard helps create interest and investment in LTSS  by effectively measuring each state’s supports and services. It also identifies areas of improvement that directly affect consumers and their families. By ranking states amongst one another, the report aims to motivate each state to improve their LTSS services. The report, linked below, measures each state’s LTSS services across several parameters, including:

  • Affordability and accessibility – Resource convenience; cost of supports and services
  • Choice of Setting and Provider – Ability to control services (i.e., self-direction)
  • Safety and Quality – Level of respect; provider and support-staffing; outcome management
  • Support for Family Caregivers – Limits dependency for family caregivers
  • Community Integration – Wide scope of LTSS services; livable and stable communities

State Performance

All 50 states were ranked into five tiers, with Tier 1 as the top performing states. Similarly, each state was ranked on each parameter in five tiers. The highest-ranking states and districts were:

  1. Minnesota
  2. Washington
  3. District of Columbia
  4. Massachusetts
  5. Colorado

The report also highlights the most improved states since 2020. These states enhanced their LTSS services the most across all parameters. Delaware was the only state to improve 10 indicators by 10% or more. Six states (Colorado, Georgia, Indiana, Kansas, Maine, and New York) improved nine indicators by 10% or more. Kentucky and Missouri also made improvements, bolstering eight indicators by 10% or more. The five worst performing states were:

  1. Tennessee
  2. Mississippi
  3. South Carlina
  4. Alabama
  5. West Virginia

Key Findings

The 2023 report took some key points from the Scorecard. The report found a shortage in long-term care insurance policies. Additionally, accessible housing and in-home nursing are still too expensive for the middle-class. The report also found more than half the country got better at creating more accessible LTSS options.


LTSS 2023 State Scorecard Report

State by State Performance

Back To Top