There are large gaps in quality of care, access to care, avoidable hospitalizations and costs, equity, and healthy lives among states, according to a new state scorecard issued by The Commonwealth Fund Commission on a High Performance Health System. Aiming Higher: Results from a State Scorecard on Health System Performance is the first report to assess how the U.S. health system is performing across these five dimensions on a state-by-state basis.
The report ranks states on 32 indicators grouped in categories that include access, quality, avoidable hospital use and costs, equity, and healthy lives, and compares each state to benchmarks that have already been achieved in states across the country. Although no single state performed at the top across all categories, some states far surpassed others. States in the Northeast and Upper Midwest often rank high in multiple areas. In contrast, states with the lowest rankings tend to be concentrated in the South.
“The differences we found between the top and bottom states were shocking, often a two- to three-fold variation or greater,” said co-author and Commonwealth Fund Senior Vice President Cathy Schoen. “Where you live clearly matters: for access to care when you need it, the quality of care you receive, and opportunities to live healthier lives.”
Across the country, the scorecard found that states that do well on access to care—particularly health insurance coverage—were also more likely to do better on quality of care. Notably, the five top-ranked states overall (Hawaii, Iowa, New Hampshire, Vermont, and Maine) all have high rates of insurance coverage, with nearly 90 percent of working-age adults insured. In contrast, in the five lowest-ranked states (Nevada, Arkansas, Texas, Mississippi, and Oklahoma), the share of adults insured ranges only between 70 and 78 percent. Download the report.
