Best performers were identified in a “first of its kind” State Long-Term Services and Supports Scorecard released last month by AARP, The Commonwealth Fund and The SCAN Foundation.

No state, however, scored in the top quartile across all 25 indicators, which included categories of Affordability and Access and Choice of Setting and Provider.

The scorecard is billed as a new way to measure state-level performance of long-term services and supports for older adults and those with disabilities.

States should not focus on just Medicaid dollars, experts warned. Rather, they should pay serious attention to nurse delegation, hospital readmission rates and reducing pressure ulcers.

“What we can say safely about the top quartile is that these states have been working for some time on improving their systems,” said SCAN’s Bruce Chernof, M.D.