2025 Scorecard on State Health System Performance – Commonwealth Fund

Posted by timmreardon on 08/16/2025
Posted in: Uncategorized.

Fragile Progress, Continuing Disparities

AUTHORS

David C. Radley, Kristen Kolb,Sara R. CollinsDOWNLOADS

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Scorecard Highlights

  • Topping the 2025 Scorecard’s overall health system rankings are Massachusetts, Hawaii, New Hampshire, Rhode Island, and the District of Columbia, based on 50 measures of health care access and affordability, prevention and treatment, avoidable hospital use and costs, health outcomes and healthy behaviors, income disparity, and equity.
  • The lowest-ranked states are Mississippi, Texas, Oklahoma, Arkansas, and West Virginia.
  • Uninsured rates fell to record lows in all states by 2023, and differences in health coverage and access to care narrowed between states. These improvements were in all likelihood due to the Affordable Care Act’s coverage expansions, recent state expansions of Medicaid eligibility, and more affordable marketplace plan premiums.
  • The number of children receiving all doses of seven recommended early childhood vaccines fell in most states between 2019 and 2023. In five states, including Nebraska and Minnesota, the decline exceeded 10 percent.
  • The infant mortality rate (deaths within the first year of life) worsened in 20 states between 2018 and 2022, with considerable variation across states.
  • Premature, avoidable deaths vary considerably across states — the rate in West Virginia is more than twice as high as the rate in Massachusetts. Not only are avoidable mortality rates higher in the United States than in other high-income countries, but they are also on the rise, even as they fall elsewhere.
  • Wide racial disparities in premature deaths are the norm in most states. In 42 states and D.C., avoidable mortality for Black people is at least two times the rate for the group with the lowest rate.
  • When it comes to having affordable health coverage, good-quality care, and the opportunity to live a healthy life, where you live matters in the U.S. Targeted, coordinated federal and state policies are needed to raise health system performance across the nation.

Read the 2025 Full Report: https://www.commonwealthfund.org/publications/scorecard/2025/jun/2025-scorecard-state-health-system-performance?