Vt. tops Commonwealth healthcare ranking; Miss. is lowest

Closing the gap between states with the best healthcare quality, access, efficiency and population health and the states that lag behind would free up funds that could insure 29 million people as well as save Medicare $20 billion to $37 billion annually, according to a newly released report by the Commonwealth Fund Commission on a High Performance Health System.

The report, which ranks states on 35 performance indicators, placed Vermont at the top of the list. Hawaii—which ranked No. 1 on the Commonwealth Fund's first state scorecard, released in 2007—and Iowa tied for second place. Minnesota placed third. Maine and New Hampshire tied for fifth. Mississippi remained the state with the worst performance, followed by Oklahoma, Louisiana, Arkansas and Nevada.

A growing number of states reported a higher percentage of adults without coverage in 2007-2008 compared with 1999-2000, the report found. Cathy Schoen, the Commonwealth Fund's senior vice president, said the trend resembled an epidemic. She also noted the figures did not reflect recent job losses from the nation's prolonged recession. The report listed nine states with at least 23% of adults younger than 65 without health benefits.

Certain hospital quality measures improved, which Commonwealth Fund officials largely credited to national efforts to publicly reporting quality and safety measures. But gains in ambulatory care quality were not as significant or as widespread, the report said.

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