Sept. 18—Poor residents of states with the best health systems had better health indicators than high-income residents of states with the lowest-rated health systems, according to an advocacy group’s national “scorecard.”

The Commonwealth Fund, a healthcare policy not-for-profit organization, issued a national analysis Wednesday that found wide variations between and within states on access to affordable health care and quality of care. The scorecard focused on the healthcare status of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, or $47,000 a year for a family of four and $23,000 for an individual. It compared their health care experiences with Americans with higher incomes—over 400 percent of poverty, or $94,000 for a family of four.

In “top-performing” states, the report, Health Care in the Two Americas: Findings from the Scorecard on State Health System Performance for Low-Income Populations, found low-income people often fared better than the national average, and even better than higher-income people in the worst-performing states on some health indicators. On indicators such as potentially preventable hospitalizations, infant mortality, smoking, and obesity, lower-income residents in high-ranked states in some northern Midwest and northeast states and Hawaii performed better than higher-income people in some southern and south central states.

An example of the inter-state divergence in health indicators was the lower likelihood that low-income elderly Medicare beneficiaries in Connecticut and Wisconsin would receive “high-risk medications” than higher-income elderly in Mississippi, Louisiana, and Alabama.

Among the benefits the report calculated if all states achieved the highest healthcare indicators in the best-performing states: 86,000 fewer people would die prematurely each year; 750,000 fewer low-income Medicare beneficiaries would be prescribed potentially dangerous medications; and nearly 9 million fewer low-income adults under age 65 would lose six or more teeth because of tooth decay, infection, or gum disease.

“We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives,” Cathy Schoen, senior vice president at the Commonwealth Fund and lead author of the report, said in a release. “Our hope is that state policymakers and health care leaders use these data to target resources to improve access, care, and the health of residents with below-average incomes.”


Publication Date: Wednesday, September 18, 2013