Aiming Higher: Results from the Commonwealth Fund Scorecard on State Health System Performance, 2017 Edition

Issue: States are a locus of policy and leadership for health system performance.Goal: To compare and evaluate trends in health care access, quality, avoidable hospital use and costs, health outcomes, and health system equity across all 50 states and the District of Columbia.Methods: States are ranked on 44 performance measures using recently available data. Key findings: Nearly all states improved more than they worsened between 2013 and 2015. The biggest gains were in health insurance coverage and the ability to access care when needed, with states that had expanded their Medicaid programs under the Affordable Care Act experiencing the most improvement. There were also widespread state improvements on key indicators of treatment quality and patient safety; hospital patient readmissions also fell in many states. However, premature deaths crept up in almost two-thirds of states, reversing a long period of decline. Wide variations in performance across states persisted, as did disparities experienced by vulnerable populations within states.Conclusion: If every state achieved the performance of top-ranked states, their residents and the country as a whole would realize dramatic gains in health care access, quality, efficiency, and health outcomes