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August 6, 2019

The best (and worst) states for health care, ranked

Daily Briefing

    WalletHub on Monday released its 2019 list of the Best & Worst States for Health Care, ranking Minnesota No. 1.

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    For the report, WalletHub used 43 measures to assess every state and Washington, D.C., on health care access, cost, and outcomes. WalletHub rated the three categories equally, though some categories included more metrics than others. For example, the:

    • Access category includes metrics on hospital beds per capita, urgent care centers per capita, and average ED wait time;
    • Cost category includes metrics on cost of a medical visit, average monthly insurance premium, and share of adults who did not see the doctor because of affordability issues; and
    • Outcomes category includes metrics on infant mortality rate, share of patients who did not receive patient-centered care, cancer rate, and share of at-risk adults with no routine doctor visit in the last two years.

    WalletHub graded each metric on a 100-point scale and calculated a weighted average for each state. A higher score represents better care at a reasonable price, according to WalletHub.


    According to WalletHub, after Minnesota, which scored 63.79 out of 100, the places with the best health care systems are:

    1. Massachusetts, which scored 62.33;
    2. Rhode Island, which scored 62.12;
    3. Washington D.C., which scored 61.38; and
    4. Vermont, which scored 60.13.

    By contrast, the states at the bottom of the rankings are:

    1. Alaska, which scored 42.21;
    2. North Carolina, which scored 42.63;
    3. Mississippi, which scored 42.76;
    4. South Carolina, which scored 42.96; and
    5. Arkansas, which scored 43.48.

    WalletHub also ranked states and Washington, D.C., individually on the three categories, with:

    • Maine ranking first for access and Texas ranking last;
    • Washington, D.C., ranking first for cost and Alaska ranking last; and
    • Massachusetts ranking first for outcomes and Mississippi ranking last.

    In addition, WalletHub highlighted the highest- and lowest-performing states on certain metrics. For instance:

    • Average monthly insurance premiums were lowest in Massachusetts and highest in Delaware;
    • Washington, D.C., had the most hospital beds per capita and Arizona had the fewest; and
    • Infant mortality was lowest in Massachusetts and highest in Oklahoma.


    Carolyn Watts, chair of the deparment of health administration at Virginia Commonwealth, discussed how uncertainty over Affordable Care Act (ACA) might influence state health care systems. Watts said, "In general, federal policy under the current administration has increased uncertainty around the ACA." Namely, she pointed to "the elimination of the individual mandate and the HHS regulation that allowed for expanded access to short term benefit plans and coverage exclusions" as forces that might lead healthier individuals to leave the ACA pools  (McCann, WalletHub, 8/5).

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