WalletHub on Monday released its 2018 list of the Best & Worst States for Health Care, ranking Vermont No. 1.
For the report, WalletHub used 40 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 included metrics on hospital beds per capita, urgent care centers per capita, and average ED wait time;
- Cost category included 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 include 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 Vermont, which scored 66.31 out of 100, the states with the best health care systems are:
- Massachusetts, which scored 65.31;
- New Hampshire, which scored 64.03;
- Minnesota, which scored 63.35; and
- Hawaii, which scored 63.08.
By contrast, the states at the bottom of the rankings are:
- Louisiana, which scored 41.14;
- Mississippi, which scored 41.53;
- Alaska, which scored 41.78;
- Arkansas, which scored 43.22; and
- North Carolina, which scored 43.98.
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
- Vermont 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 highest in Alaska;
- Washington, D.C., had the most hospital beds per capita and Idaho had the fewest; and
- Infant mortality was lowest in Vermont and highest in Alabama.
Amol Navathe, an assistant professor of medical ethics and health policy at the University of Pennsylvania, discussed how health reform legislation has influenced health care delivery in recent years. "Reform of health care delivery has been one of the major, yet perhaps hidden, successes of health reform. Health care organizations and clinicians are now engaged in a major cultural and operational shift where they think about maximizing the value of care outside of just their four walls."
Separately, Angela Snyder, an associate professor in public management at Georgia State University, said, "Health care reform has pushed integration of public and private health care systems within states." She added, "All states have moved to a more coordinated system enabling consumers to find and enroll in health coverage" (Ellison, Becker's Hospital Review, 8/6; McCann, WalletHub, 8/6).
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