And The Best State For Health Care Is ...

GENERIC health doctors CBS/AP

Hawaii leads and Oklahoma lags on a new state scorecard about health system performance.

The scorecard is the first of its kind from the Commonwealth Fund, a private foundation focused on health care.

The Commonwealth Fund rated states based on 32 indicators, including access,
quality, cost, insurance, preventive care, potentially avoidable hospital visits, and premature death (death before age 75).

The top five states in order are Hawaii, Iowa, New Hampshire, Vermont, and Maine.

The bottom five states are Nevada, Arkansas, Texas, Mississippi, and Oklahoma.

Wide Range

The top-rated states scored two to three times higher than the lowest-ranked
states.

"Where you live really matters in terms of your experience with the American health care system," Commonwealth Fund President Karen Davis told
reporters at a news conference.

"The wide variation and gaps between leading and lagging states add up
to substantial human and economic cost for the nation," says Cathy Schoen,
the Commonwealth Fund's senior vice president for research and evaluation.

Schoen says that if all states equaled the top-rated states, there would be 90,000 fewer premature deaths before age 75 from conditions such as diabetes, infection, respiratory disease, and treatable cancers. In addition, 22 million more adults and children would be insured, cutting U.S. uninsured rates in half.

Room for Improvement

Every state has room for improvement — even those leading the scorecard —
notes Schoen, who worked on the scorecard with other experts.

"Each of the top states has some indicators in the bottom half of the
state distribution," Schoen says. In other words, though those states may
rank highly overall, they're not acing every category in the scorecard.

Insurance tracked with the states' ratings.

"In general, states that did well in the overall rankings had the lowest
rates of uninsured in the nation, and states that did poorly had the highest
rates of uninsured in the nation," Schoen says.

But high ratings didn't always mean high costs.

"Indeed, some states have high quality and lower cost," Schoen says.
She adds that "high costs tend to track higher rates of potentially
preventable hospital use and 30-day re-admission rates, indicating a need for a focus on prevention and primary care and care coordination."

State Rankings

Here is the list of how the states and Washington, D.C., ranked overall.
States with the same ranking are listed together.


  1. Hawaii

  2. Iowa

  3. New Hampshire, Vermont

  4. Maine

  5. Rhode Island

  6. Connecticut

  7. Massachusetts

  8. Wisconsin

  9. South Dakota

  10. Minnesota

  11. Nebraska

  12. North Dakota

  13. Delaware

  14. Pennsylvania

  15. Michigan

  16. Montana, Washington

  17. Maryland

  18. Kansas

  19. Wyoming

  20. Colorado, New York

  21. Ohio, Utah

  22. Alaska, Arizona, New Jersey

  23. Virginia

  24. Idaho, North Carolina

  25. Washington, D.C.

  26. South Carolina

  27. Oregon

  28. New Mexico

  29. Illinois

  30. Missouri

  31. Indiana

  32. California

  33. Tennessee

  34. Alabama

  35. Georgia

  36. Florida

  37. West Virginia

  38. Kentucky

  39. Louisiana, Nevada

  40. Arkansas

  41. Texas

  42. Mississippi, Oklahoma


By Miranda Hitti
Reviewed by Louise Chang
© 2007 WebMD, Inc. All rights reserved

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