We recently reported on the high cost of living for older adults in Massachusetts as as measured by the Elder Index calculated by the Gerontology Institute at the University Massachusetts Boston.
The good news, however, is that we actually get something for those expenses. According to a Long-Term Services and Supports Scorecard prepared by the AARP, Massachusetts ranks fourth in the nation in the level of supports provided to older adults, people with disabilities and family caregivers, just behind Minnesota, Washington and the District of Columbia. Colorado fills out the group of Tier 1 states that consistently scored high on the 50 indicators measured in the Scorecard.
The Scorecard measures each state’s long-term care system based on affordability, access, choice, safety, quality, support for family caregivers, community integration, and equity. The AARP reports progress in many states with a majority now spending more Medicaid (MassHealth in Massachusetts) on home and community based care rather than on care in nursing homes. It also notes the expansion of “self direction” programs that permit beneficiaries to direct their own care, the number of participants more than doubling from 740,000 in 2009 to 1.5 million in 2021.
Massachusetts scored highest on measures of choice of setting and provider of care, in second place nationally, but not as well on measures of safety and quality and support for family caregivers, where it ranked 14th and 13th, respectively. Surprisingly, Massachusetts ranked fourth nationally on AARP’s measure of affordability and access, no doubt stronger on access than on affordability since we ranked 29th and 44th, respectively, on home care and nursing home costs.
Drilling down on the AARP data can provide guidance on how Massachusetts (and other states) might focus efforts to improve care and supports. For instance, Massachusetts ranks 50th on the percentage of home health patients who report hospital admissions. (Dead last would be 51st since the District of Columbia is included.) And it ranks 40th in the inappropriate use of antipsychotic medications by nursing homes.
In short, we’re doing pretty well in Massachusetts, but there’s still ample room for improvement.