What is the State of Healthcare in Your State?

The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states, according to the 2009 state scorecard report of the Commonwealth Fund Commission on a High Performance Health Systems.

The report, Aiming Higher: Results from the 2009 State Scorecard on Health System Performance, is a follow-up to the Commission's 2007 State Scorecard report; it ranks states on 38 indicators in the areas of access, prevention/treatment quality, avoidable hospital use and costs, healthy lives, and equity.

In 2009, Vermont, Hawaii, Iowa, Minnesota, Maine, and New Hampshire lead the nation as top performers on a majority of scorecard indicators. Leading states set new, higher benchmarks on a majority of indicators. Conversely, states in the lowest quartile often lag the leaders on multiple areas and the gaps have grown wider in multiple areas.

"Leading states have raised the bar for better access, quality of care, and reducing disparities," said Commonwealth Fund Senior Vice President and study co-author Cathy Schoen. "Where you live in the U.S. matters in terms of your health care, and it shouldn't.”

The sharp variation across states spans access, quality of care, costs, and lives. For example, rates of hospital readmissions (within 30 days of a previous hospital stay) among Medicare beneficiaries ranged from a high of 23 percent of hospital admissions in Nevada to a low of 13 percent in Oregon. The percent of adult diabetics getting recommended preventive care ranged from a low of 33 percent in Mississippi to a high of 67 percent in Minnesota as of 2006–07, a new high. On these and other measures, the lowest ranked states would have to improve 40 percent to 100 percent on average to achieve the performance of top ranking states.

The scorecard points to substantial opportunities to improve. If all states could reach the level achieved by the top performing states:

• Twenty-nine million more people would have health insurance—cutting the number of uninsured by more than half;
• Nearly 78,000 fewer adults and children would die prematurely every year from conditions that could have been prevented with timely and effective health care;
• Nine million more adults age 50 and older would receive recommended preventive care, and almost 800,000 more children would receive key vaccinations;
• Five billion dollars could be saved annually by avoiding preventable hospital admissions and readmissions for vulnerable elderly and disabled residents.

You can download the report Aiming Higher by clicking here. An interactive map that allows users to look at and download individual state information and compare states on various measures is available at www.commonwealthfund.org/Charts-and-Maps/State-Scorecard-2009.aspx.