HealthNews Dozen: Top 12 States in Health Care

At a time when the issue of health care dominates news coverage and the attention of the government, as well as the public it represents, it only seems appropriate that the latest study is released with rankings of the states based on the performance of their health care systems. The state of health care in America is important each day of the year, but with the current concentration on accessibility, pricing, availability, and quality of the system, any analysis of the system rings particularly true.

The 2009 State Scorecard on Health System Performance was conducted by the Commonwealth Fund, a private foundation that conducts independent research on health care issues in order to inform citizens and, in some cases, issue grants to further health care and corresponding policy. This was the second such report done on a nationwide basis with a state breakdown, the last released in 2007.

Consisting of 38 indicators of health care access, quality, costs, and outcomes, all of the 50 states plus the District of Columbia were ranked to show which states need improvement and others that can lead the way for the nation by showing what it takes to provide the best health care for its residents. Vermont came out on top of that list, ranking in the top quartile of all categories, with Hawaii, Iowa, and Minnesota in a close second, each of them only ranking in the second quartile in one category.

The absolute worst states on the list were Oklahoma and Mississippi, both finding themselves with the lowest ratings in all five major categories: access, prevention and treatment, avoidable hospital use and costs, equity, and healthy lives. Oklahoma showed no improvement over the 2007 study, and Mississippi actually lost ground in the past two years. Louisiana, Arkansas, and Nevada were close to the bottom of the list, and Texas was the sixth worst state in the nation.

The authors of the study noted that there were some improvements overall, especially in the areas of children’s coverage and hospital and nursing home care, both due to the efforts of the federal government, funding the former and requiring public reports from the latter. But overall, there was no vast improvement in any one state, as many stayed in the same range or dropped as when studied two years prior.

According to the results, the opportunities available by all states achieving the level of any of the top states on the list would be invaluable. Efforts to improve so drastically would grant insurance to 29 million more people, prevent the deaths of 78,000 people who will likely die prematurely from lack of timely and comprehensive care, allow 800,000 more children to receive vaccinations, give preventative care to 9 million more elderly people, and save $5 billion per year by avoiding preventable hospital admissions for the elderly and disabled.

Commonwealth Fund President Karen Davis reiterated, “The differences we see among the states translate to real lives and dollars. If we can enact health reforms that give all states the opportunity to do as well as the best states we will save lives, improve quality, and cut costs. And, the good news is that these aren’t pie in the sky goals - we know they are attainable because we see it happening in the states at the top of the pack.”

Overall, the report noted that health care coverage has declined in the past two years while prices rose, and there is a desperate need for comprehensive national reforms to expand coverage, improve quality, and rein in costs. In addition, certain areas of the country, like the southern states, simply cannot currently compete with the northern and northeastern states. The authors feel that the only way to eliminate those drastic disparities is to enact health care reforms on a federal level to ensure compliance and an even playing field for every American citizen.