The NCSL Blog


By Ashley Noble

The Commonwealth Fund has released a new 2017 Edition of "Aiming Higher: Results from the Commonwealth Fund Scorecard on State Health System Performance."

Doctor with patientThe report follows up on the Commonwealth Fund’s previous scorecards in analyzing state performance and progress across 44 indicators in five broadly defined categories, including: Access and Affordability, Avoidable Hospital Use and Costs, Equity, Healthy Lives, and Prevention and Treatment.

All states improved in at least one category over the course of 2013-15.

Massachusetts continues to lead the nation in levels of insurance coverage for children and adults. Vermont was identified as the state with the best-performing health care system overall. Kentucky’s health care system improved in 21 indicators—the most of any state, followed closely by Oklahoma. States with higher rates of insurance coverage tended to have better performing health care systems and health outcomes overall.

Levels of health insurance coverage continued to improve in the states. People with health insurance coverage are more likely to have a provider whom they see for routine care and are more likely to have received care recently than those who do not have health insurance.

While significant improvements were measured, the report also found areas that may be cause for concern. Premature death rates are up across the U.S. Although most of this increase can be attributed to largely preventable chronic health conditions, deaths related to alcoholism and opioid abuse have significant impacts on premature death rates. The report also found significant disparities in premature deaths rates for African Americans compared to Latino and white populations.

The report recommends that states adopt payment and delivery reforms as a means of improving health quality and outcomes across the board. In particular, the report recommends focusing on primary care as a means of reducing health disparities.

Ashley Noble is a policy specialist in NCSL's Health program.

Email Ashley

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.