The Commonwealth Fund recently announced an updated version of their State Scorecard on Health System Performance. This report ranks states in five areas: access; prevention and treatment; avoidable hospital use and costs; equity; and healthy lives. Vermont passed Hawaii as the top-ranking state, due in part to comprehensive delivery system reforms and coverage expansion passed in 2006. Rounding out the list of most highly ranked states were Hawaii, which tied with Iowa for second, Minnesota, Maine and New Hampshire. Mississippi fell below Oklahoma to become the most poorly ranked state.
Following are some of the cross-cutting findings from this year’s report:
- Coverage for adults fell, while insurance rates for children held steady or increased, largely due to the State Children’s Health Insurance Program (SCHIP).
- Health care quality improved in hospitals, nursing homes and home health agencies. The authors of the report credit performance improvement initiatives and increased public reporting in the Medicare program.
- Ambulatory care quality and measures of care coordination did not improve – and in some cases it declined.
- Large differences remain both within and between states in the quality of care received by high- and low-income individuals. The “equity gap” is widening.
In an effort to improve the type of health system performance measured in the Scorecard, The Commonwealth Fund and AcademyHealth are working with several selected states in the State Quality Improvement Institute. This initiative was designed to promote delivery system improvement and payment reform to achieve system-wide improvements in quality and cost containment. The eight participating states are: Colorado, Kansas, Massachusetts, Minnesota, Ohio, Oregon, Vermont, and Washington.
