Study: 2018’s Best & Worst States for Health Care
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Study: 2018’s Best & Worst States for Health Care


USA — August 7, 2018

This Monday, WalletHub released a new study on Health Care services in the U.S.

According to the CDC, 88.1 percent of the population has a regular place to go for medical care. But the cost and service quality of that care can vary widely from state to state. The overall health of the population, more advanced medical equipment and a general lack of awareness regarding the best types of treatment, can all affect costs. Today, the average American spends more than $10,000 per year on personal health care, according to the most recent estimates from the Centers for Medicare & Medicaid Services. That’s about 17.9 percent of the U.S. GDP.

But higher costs don’t necessarily translate to better results. According to a study by the Kaiser Family Foundation, the U.S. lags behind many other wealthy nations on several measures, such as health coverage, as well as life expectancy and disease burden, which measures longevity and quality of life. However, the U.S. has improved in providing healthcare access for people in bad health, and healthcare cost growth has somewhat slowed.

Conditions aren’t uniform across the U.S., however. To determine where Americans receive the best and worst health care, WalletHub compared the 50 states and the District of Columbia across 40 measures of cost, accessibility and outcome.


In order to determine the best and worst states for health care, WalletHub compared the 50 states and the District of Columbia across three key dimensions: 1) Cost, 2) Access and 3) Outcomes.

WalletHub evaluated those dimensions using 40 relevant metrics, e.g. Cost of Medical Visit, Share of Adults with No Doctor Visits Due to Cost, Average Emergency-Room Wait Time, Physicians per Capita, Nurse Practitioners per Capita, Share of Insured Children, Infant Mortality Rate, Life Expectancy, Cancer Rate and others. Each metric was graded on a 100-point scale, with a score of 100 representing the best health care at the most reasonable cost.


Finally, researches determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.

Below are TOP10 States for Health Care:

1. Vermont. Score: 66.31

2. Massachusetts. Score: 65.31

3. New Hampshire. Score: 64.03

4. Minnesota. Score: 63.35

5. Hawaii. Score: 63.08

6. Rhode Island. Score: 62.98

7. Colorado. Score: 62.69

8. District of Columbia. Score: 62.08

9. Iowa. Score: 61.94

10. Maryland. Score: 61.86

Here is an expert opinion on the subject from Robert D. Lieberthal Ph.D., Assistant Professor, Department of Public Health, University of Tennessee Knoxville:

  • Major insurers including Blue Cross, Aetna and Humana have pulled out many state-run insurance exchanges, leaving residents of some counties with few, if any, options for coverage. What effects will this have for the market in the future?

Many of the companies you mention have offered coverage and then stopped offering coverage in certain areas. Other new entrants have stepped in to fill the gap. Consumers should plan for the continuing need to shop for new health insurance plans, or new insurance companies, every year.

  • How has the recently enacted health-care reform reshaped state health care systems?

Health-care reform has mainly had the effect of standardizing health insurance markets across states. The federal government has taken more responsibility for health insurance regulation. State health care systems now have more responsibility for deciding how to utilize federal programs in order to suit the needs of their state’s residents.

  • How has it impacted businesses and the provision of employer-sponsored plans?

Health care reform has made government provided health insurance relatively more important and employer-sponsored plans relatively less important. Employer-sponsored plans still provide insurance for a significant proportion of the US population.

  • What tips do you have for a person looking to find the right balance between the cost of premium and level of coverage?

People should be looking to shop around for health insurance every year. They also should be getting ready to shop around for care because many insurance plans come with high deductibles. Consumers in these plans often can use health savings accounts (HSAs) to save up for care and also reduce the amount they pay in taxes. HSAs also are portable, and do not rely on a specific insurance company.

  • What are the most important steps Americans can take to minimize health-related expenditures?

Shopping around is key. There is a large variation in price for many health care services. “Smart shoppers” often can obtain lower costs without sacrificing quality.

  • What are the most important metrics for evaluating state healthcare systems?

Important metrics include whether the state government has applied for the Medicaid expansion offered in the Affordable Care Act (ACA). Other metrics include whether the state has applied for waivers from the federal government to experiment with the delivery of health care and health insurance.

Another expert opinion from Richard C. Boothman, Executive Director of Clinical Safety, UMHS, Chief Risk Officer, Michigan Medicine & an Adjunct Assistant Professor at University of Michigan Medical School, Department of Surgery:

I only see what most Americans completely miss: that we all pay for the uninsured and underinsured. No American hospital can refuse to care for patients who have emergencies regardless of their insured status or ability to pay. Our failure to offer coverage for every American in whatever form, (single payer, subsidized insurance) causes most uninsured people to miss any preventative health care or even urgent care, leading to extreme medical emergencies that are far more costly both from a medical cost perspective as well as a social perspective. Little of the cost of what is ultimately the most-expensive medical care actually gets reimbursed, what does get reimbursed comes at the government's (taxpayers') expense, and virtually none of the social costs are ever addressed. The current predicament is stupid financially, corrosive socially, and often-devastating individually. Regardless of political affiliation, we all need to pay attention to this and insist that it gets fixed, because it IS fixable and controllable if we stop playing ridiculous political games. This cycle and human drama plays out every single day in our emergency room. The cost to all of us is staggering and unnecessary.

Author: USA Really