Raising Expectations

Impact of Improved Performance

States can improve their LTSS system performance in numerous ways. Improvement to levels achieved by top-performing states would make a difference to the 11 million older people and adults with physical disabilities who have LTSS needs,² and their family caregivers, in terms of access, choice, and quality of care. For example:

• If all states' public LTSS safety nets were as effective as that of Maine in covering low-income people with disabilities, an additional 667,171 individuals would receive coverage through Medicaid or other public programs. Such coverage would link people with disabilities and limited incomes to health care as well as long-term services and supports.
• States that effectively inform people with LTSS needs about home and community care options and offer an array of service choices can address the preferences of consumers in a cost-effective manner. If all states rose to Minnesota's level of performance on this measure, 201,531 people could avoid costly and unnecessary nursing home use.
• Many nursing home residents with low care needs can be, and would prefer to be, served in the community. If all states achieved the rate found in Maine, 163,441 nursing home residents with low care needs would instead be able to receive LTSS in the community.
• Excessive transitions between care settings such as nursing homes and hospitals reflect poor coordination of services and are correlated with poor quality of care. If all states matched the performance of Minnesota, 120,602 hospitalizations could be avoided, saving an estimated $1.3 billion in health care costs.