Methodology

For the report, WalletHub used 44 measures to assess each state and the District of Columbia on healthcare cost, access, and outcomes. WalletHub weighted the three categories equally, though some categories included more metrics than others. For example:

• The cost category includes metrics on the cost of a medical visit, average monthly insurance premium, average hospital expenses per day as an inpatient at community hospitals, and the share of adults who did not see the doctor because of affordability issues.
• The access category includes metrics on hospital beds per capita, urgent care centers per capita, adoption of telehealth services, and average ED wait time.
• The outcomes category includes metrics on infant mortality rate, share of patients who did not receive patient-centered care, cancer incidence 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. Having a higher score represented having better care at a reasonable price.

Findings

According to WalletHub, after Minnesota, which scored 64.96 out of 100, the states with the best healthcare systems in 2023 were:

2. Iowa, which scored 64.45

3. Rhode Island, which scored 64.22

4. North Dakota, which scored 63.90

5. Utah, which scored 62.24

Meanwhile, the states at the bottom of the list were:

51. West Virginia, which scored 44.26

50. Mississippi, which scored 46.61

49. Alaska, which scored 47.02

48. Alabama, which scored 47.17

47. Louisiana, which scored 47.40

WalletHub also ranked states and the District of Columbia individually on the three categories, with:

• Minnesota ranking first for cost and Alaska ranking last
• Maine ranking first for access and Alabama ranking last
• Utah ranking first for outcomes and Mississippi ranking last

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

• Average monthly insurance premiums were lowest in Utah and highest in Wyoming and West Virginia
• The District of Columbia had the most hospital beds per capita while Utah had the fewest
• The infant mortality rate was lowest in North Dakota and highest in Mississippi
• The District of Columbia had the most physicians per capita while Idaho had the fewest

Expert insights

WalletHub also spoke with ten healthcare experts and asked them four questions Americans should consider as they "anticipate changes to their health care in both the short and long terms."

When asked what Americans can do to minimize health-related expenditures, Maria Livaudais, an assistant professor of health sciences at California State University-East Bay, said Americans should utilize preventive services. "Make appointments to see your primary care physician, become familiar with telehealth services provided by your insurer, and stay on top of screenings, vaccines, and check-ups," she said.

Whitney Zahnd, an assistant professor in the department of health management and policy at the University of Iowa's College of Public Health, agreed, noting that insurers are often required to cover "well visits" and other preventive services like cancer screenings, and that Americans should take advantage of that.

"Identifying health concerns earlier, when they are more manageable and treatable, is best not only for your health but also for your pocketbook," she said.

When asked what the major issues facing healthcare in 2023 are, Betsy Cliff, assistant professor in the department of public health sciences at the University of Chicago, pointed out cost and affordability.

"We do not like to use the word 'ration' in the United States to refer to health care, but that is what effectively happens: we ration health care to those who can afford it," she said. "It is almost a given these days that someone with a major health expense will start a GoFundMe page to help pay for it. With all the resources we have in this country, I wish we did not have people resorting to ad hoc funding campaigns to pay for medical expenses." (McCann, WalletHub, 7/31)

Consumer navigation is a changing landscape, shaped by a confluence of factors. Healthcare industry stakeholders must navigate complex trends to capture consumers’ attention. We've identified six key drivers that are shaping consumer preferences and behaviors across the industry, read our insights to help your organization think about the present and future of consumerism.