WalletHub on Monday released its 2020 list of the Best & Worst States for Health Care, ranking Massachusetts as No. 1.
For the report, WalletHub used 44 measures to assess every state and the District of Columbia on health care access, cost, and outcomes. WalletHub rated the three categories equally, though some categories included more metrics than others. For example, the:
The access category also included a new measure this year: states with the best health infrastructure for handling the novel coronavirus. WalletHub pulled states' scores for that measure from its "States with the Best Health Infrastructure for Coronavirus" rankings, which WalletHub released in May. For those rankings, WalletHub evaluated states based on public health emergency preparedness, public hospital system quality, availability of emergency centers and services, public health care spending, and other metrics.
For WalletHub's Best & Worst States for Health Care rankings, the best health infrastructure for coronavirus measure was weighted three times the weight of the other measures within the access category.
WalletHub graded each metric on a 100-point scale and calculated a weighted average for each state. Having a higher score represented having better care at a reasonable price, according to WalletHub.
According to WalletHub, after Massachusetts, which scored 63.47 out of 100, the places with the best health care systems for 2020 were:
By contrast, the states at the bottom of the rankings were:
WalletHub also ranked states and the District of Columbia individually on the three categories, with:
In addition, WalletHub highlighted the highest- and lowest-performing states on certain metrics. For instance:
WalletHub spoke with six health care experts and asked them four "key questions" for Americans to consider as they "anticipate changes to their health care in both the short and long terms":
On minimizing health-related expenditures, many of the experts who spoke with WalletHub emphasized the importance of preventive care and living healthy.
Diane Howard, an associate professor in the department of health systems management at Rush University, said, "Americans have to take responsibility for our health to control health-related expenditures, particularly health that is in each individual's control. These are things everyone knows—eat correctly, exercise, limit stress, get regular check-ups, and know your health care numbers (cholesterol, blood pressure, weight)."
John Huppertz, associate professor and director of health care management at Clarkson University's Reh School of Business, said in addition to focusing on healthy behaviors, consumers should "learn how to access the most appropriate level of care for the problem they have." For example, Huppertz said, people shouldn't "go to the [ED] for something that can be treated by [their] primary care provider or at urgent care." He noted that "a high percentage of cases seen in the [ED] could be handled in less acute settings."
When it comes to finding the right balance between health insurance premium costs and coverage levels, Naomi Zewde, an assistant professor at City University of New York's School of Public Health, said, "It is not the ideal trade-off for anyone to make." She explained, "The narrower network might be the least-bad trade-off, though. If you can minimize your deductible and co[payments], which means you won't be deterred from seeking care when you end up needing it and maintain an affordable monthly premium, the least bad trade-off might be to only have a limited number of doctors and hospitals that accept your insurance."
On Medicare-for-All proposals, which largely would transition the country to a single-payer health system, the experts largely were split over whether they supported such proposals, though many highlighted some of the complexities that could make it difficult for such a system to succeed in the United States.
And when it comes to what local officials can do to better support hospitals and providers through the coronavirus epidemic, Atul Gupta, assistant professor of health care management at the University of Pennsylvania's Wharton School, said, implementing measures to curb the virus' spread, such as social distancing requirements; increasing access to coronavirus testing, ensuring quick results, and sharing those results with employers; and "well-executed contact tracing and isolation/quarantining to prevent spread" could help. "I think local authorities are already doing some or all of these things, though some are doing it better than others and unfortunately all are learning on the job," he said (McCann, WalletHub's "2020's Best & Worst States for Health Care," 8/3; McCann, WalletHub's "States with the Best Health Infrastructure for Coronavirus," 5/26).
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