The State Long-Term Services and Supports Scorecard found wide variation in how states perform across the 25 indicators that comprise the key dimensions of a high-performing system.The Scorecard is designed to help states improve the performance of their long-term services and supports (LTSS) systems by targeting opportunities for improvement. Looking to other states that performed better in specific areas can inform potential paths for improvement. Leading states do well on multiple indicators, but even states with a low ranking scored in the top quartile for at least one indicator. A series of case studies provides a deeper context for understanding how high-, medium-, and low-ranking states performed for the baseline Scorecard, and how they are already striving to improve LTSS for older people and adults with physical disabilities. This case study focuses on Idaho.