More states improved their performance on most healthcare quality measures, according to the Commonwealth Fund's latest Scorecard on State Health System Performance, the first to measure the effects of coverage expansions under the Affordable Care Act.
The Commonwealth Fund bases its scores on more than 40 indicators, including patients 50 and older receiving recommended screenings, adults who forego care due to cost concerns, infant mortality and number of insured adults. The new study shows overall improvement over last year's middling report.
The scorecard found that:
- The Northeast and Upper Midwest accounted for most of the top performers, with Minnesota, Vermont, Connecticut, New Hampshire, Rhode Island, Hawaii and Massachusetts retaining their places at the top from 2014
- Washington improved enough to enter the top quartile of performers for the first time
- The percentage of working-age adults without health insurance declined in nearly every state and dropped by at least three points in 39 states
Researchers added that the full effects of the Affordable Care Act may take years to be visible in the numbers. Several states, including Oklahoma, Kentucky, Tennessee and Louisiana ranked in the bottom performance quartile, but were also among the states that improved on the largest number of indicators. Louisiana, for example, led all states in indicators improved, with 16, while worsening on only three. The state has not yet expanded its Medicaid program, but governor-elect John Bel Edwards (D) has pledged to pass the expansion upon assuming office, USA Today reports.
Kentucky, which was ranked 40th on performance, improved on 13 indicators and was the top state for declines in the coverage rate among adults. However, Gov. Matt Bevin (R), who took office this week, has pledged to scale back the Medicaid expansion passed under his Democratic predecessor Steve Beshear, according to the newspaper.
The report comes a few months after the Commonwealth Fund's recent finding that quality of care has improved nationwide but continues to lag behind other developed countries on measures such as health-related quality of life and cost-related access barriers.