As baby boomers age, concerns regarding retirement are dwarfed only by worries about long-term health care during their later years. How can you know, for example, how your state ranks in this very important corner of the health care industry?

Wonder no more. The AARP Public Policy Institute, along with the SCAN Foundation and the Commonwealth Fund, has just published its Raising Expectations, 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers.

Based upon benchmarks first promulgated in 2011, the report rates each state and the District of Columbia according to five performance categories:

  • Affordability and access
  • Choice of setting and provider
  • Quality of life and quality of care
  • Support for family caregivers
  • Effective transitions

At the bottom of the heap lie Kentucky and Alabama, with Mississippi, Tennessee, Indiana and West Virginia close behind. The only state to be top-rated in all classifications is Minnesota.


Affordability still a problem everywhere
One issue that continues to affect each state is the fact that long-term care is expensive, outstripping the resources of middle-income families. Even in the highest-ranked states, this is an ongoing problem, according to the report.

Nursing home care is the most costly, gobbling up 246% of older households' median income per year. Home health care is much less expensive, but still consumes 84% of annual median income.

In addition, the study found that very few Americans have long-term care insurance, with only 10% of those aged 50 or older holding such a policy.

Why these 6 states are ranked so low
If affordability is a problem all over the country, why do the aforementioned six states get such lousy overall scores? Because each state's overall performance is compared to the median of all states, as well the best-ranked state, on 26 particular metrics.

For example, though Minnesota was the top-ranked state overall, it came in 49th in one of the cost metrics, median annual home care private pay cost as a percentage of median household income for those aged 65 years and older, due to its high costs. The No. 1 state in that specific category, the District of Columbia, was tops with only 47%, while Minnesota came in with 100% -- meaning that its costs would eat up every last cent of an elder's median annual income.

The Scorecard's interactive features allows you to compare each state to others, as well as view individual score sheets that can give you an enlightening snapshot of how each of these states are performing in the long-term care arena – as well as insights into how each state "earned" its own ranking. If you are a boomer who wants to plan ahead for your long-term health care, this study is worth its weight in gold.

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