National Core Indicators – Aging and Disabilities

Measuring the performance of LTSS programs for seniors and adults with physical disabilities

In partnership with ADvancing States (formerly NASUAD) and participating states, we work to assess, compare, and improve programs that provide long-term services and supports to older adults and people with physical disabilities. At the core of this effort is a consumer survey, gauging people’s satisfaction with services and the impacts on their quality of life.


The National Core Indicators – Aging and Disabilities (NCI-AD) grew out of state aging and disabilities agencies’ desire for valid data to address important social, community, and person-centered goals as well as quality of life. 

The project has grown rapidly since its 2015 launch: Already 20 states administer the NCI-AD survey.  

  • Evaluation
  • Quality Improvement
  • Systems Design
  • Data Collection and Analysis
  • Technical Assistance and Training
  • Dissemination

Establishing Quality Measures

Gathering direct input from service users through in-person surveys, NCI-AD helps states measure and compare satisfaction with their LTSS delivery systems and service recipients’ quality of life and outcomes in domains such as: 

  • Community Participation and Relationships
  • Everyday Living, Work, and Affordability
  • Choice and Decision Making, Self-Direction, and Control
  • Rights and Respect and Safety
  • Service Coordination, Care Coordination, and Access
  • Health Care, Wellness, and Medications

Measuring performance 

States that participate in NCI-AD typically administer the NCI-AD survey on an annual basis, but others conduct the survey on some other recurring schedule. The NCI-AD team, composed of experts from HSRI and ADvancing States, assists states by:

  • Providing valid and reliable measures, data collection instruments, and protocols
  • Offering ongoing technical assistance throughout project implementation
  • Aggregating, cleaning, analyzing and reporting the results
  • Assisting in data interpretation and comparisons

States can use the resulting data to track and compare their performance at the program level (including various Medicaid HCBS programs, Older Americans Act programs, state-funded programs, nursing facilities), by accountable entity (managed care organizations, for example) and on the system level. They can also compare their results to the performance of other states’ service systems and to the average across participating states.  

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More than 17,000 older adults and adults with disabilities responded to the 2017-18 NCI-AD survey. Across states and setting types, 69% of respondents said they felt in control of their lives. 

The results 

By maintaining, cleaning and analyzing the data, and producing national and state-specific NCI-AD reports, we support states in:  

  • Setting priorities and track quality improvement on systems level, as well as in individual programs and/or accountable entities
  • Setting quality assurance benchmarks
  • Complying with CMS quality assurance requirements
  • Increasing awareness
  • Sharing performance data with stakeholders and policy-makers
  • Formulating policy positions
  • Establishing actionable goals
  • Supporting initiatives
  • Identifying additional data needs 
Project Partner(s):

ADvancing States

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