A State-By-State Scorecard on Health System Performance

By Richard Shank

Rutgers University researchers and The Commonwealth Fund released a yearly report outlining each state’s health system performance. The report assesses each state on 38 achievable benchmarks related to care access, quality, costs, and health outcomes. Overall, the report concludes that the nation’s health systems are under considerable stress, primarily caused by weakened health insurance coverage for adults and rising health care costs. (On a positive note, children’s access to health care improved nationwide by legislative reforms.)

The 2009 State Scorecard on Health System Performance is the second edition of a new research series that began in 2007. Its intent is to allow state stakeholders to compare their health system performance to one another in the hopes of motivating workable reform strategies.

The 2009 edition’s conclusions are similar to the first; “When it comes to access to care when you need it, the quality of care you receive, and the likelihood of living a healthier life, where you live matters.” Top-performing states in 2007 continue to outpace the other states on the key indicators. For the long-term care industry, the good news is that key indicators of nursing home and home health care quality have improved in all states. The report’s findings also state:

• Medicare performance measures have improved the quality of care for heart attacks, heart failure, pneumonia, and the prevention of surgical complications in all states.
• All states saw a decline in rates of pressure ulcers, physical restraints, and pain for nursing home residents, as well as increased mobility in home health care recipients.
• Insurance coverage eroded for adults and held steady for children in most states.
• A majority of states display poor care coordination and inefficient use of care resources, as indicated by an increased rate of hospital and nursing home readmission.
• The states with the highest readmission rates have the highest health care costs overall.
• The Health Equity Gap increased in most states between low income and high income demographic groups.

For more information, access the report at http://www.commonwealthfund.org

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