From the summary:
The Commonwealth Fund’s Scorecard on State Health System Performance, 2014, assesses states on 42 indicators of health care access, quality, costs, and outcomes over the 2007–2012 period, which includes the Great Recession and precedes the major coverage expansions of the Affordable Care Act. Changes in health system performance were mixed overall, with states making progress on some indicators while losing ground on others. In a few areas that were the focus of national and state attention—childhood immunizations, hospital readmissions, safe prescribing, and cancer deaths—there were widespread gains. But more often than not, states exhibited little or no improvement. Access to care deteriorated for adults, while costs increased. Persistent disparities in performance across and within states and evidence of poor care coordination highlight the importance of insurance expansions, health care delivery reforms, and payment changes in promoting a more equitable, high-quality health system.
The mixed performance of states’ health systems over the five years preceding implementation of the Affordable Care Act’s major reforms sends a clear message that states and the nation are still a long way from becoming places where everyone has access to high-quality, affordable care and an equal opportunity for a long and healthy life. In tracking 42 measures of health care access, quality, costs, and outcomes between 2007 and 2012 for the 50 states and the District of Columbia, The Commonwealth Fund’s Scorecard on State Health System Performance, 2014, finds that, on a significant majority of measures, the story is mostly one of stagnation or decline. In most parts of the country, performance worsened on nearly as many measures as it improved….
Supplemental Data Tables