Healthcare affordability scorecard: Where does your state rank?

Massachusetts topped the list of a scorecard rating states on their adoption of policies to improve affordability of healthcare, but no state earned a perfect score. 

The Healthcare Affordability State Policy Scorecard, which Altarum's Healthcare Value Hub released Nov. 3, shows many states have work to do to address the affordability of healthcare for residents. It also provides a guide for each state on where to focus regulatory and reform efforts. 

Altarum, a nonprofit research and consulting organization, rated 47 states and the District of Columbia on four policy areas: 

  • Reducing low-value care
  • Curbing excess prices
  • Making out-of-pocket costs affordable, and 
  • Extending coverage

States were also ranked on their outcomes in four areas:

  • Private payer inpatient prices related to the Medicare allowed amount
  • Rates of known low-value services delivered by providers
  • Percent of population that is uninsured, and 
  • Percent of population that decided to forgo needed care due to cost 

The scorecard is retrospective and only scored states on policies implemented as of Dec. 31, 2020. Each state received a policy score and an outcome score, and the two were combined for the overall ranking. Hawaii, New Jersey and South Carolina did not receive an overall ranking because of inadequate data. Access more information about the methodology used for the scorecard here

Here are the overall rankings for each state: 

1. Massachusetts
2. Rhode Island
3. Vermont
4. Oregon
5. Colorado
6. Maryland
7. Washington
8. Minnesota 
9. Maine
10. Delaware
11. California
12. New York
13. New Hampshire
14. Virginia
15. Connecticut
16. District of Columbia
17. Iowa
18. Michigan
19. Wisconsin
20. Ohio
21. Illinois
22. Pennsylvania
23. North Dakota 
24. New Mexico
25. Utah
26. South Dakota
27. Louisiana
T-27. Nebraska
29. Kentucky 
30. Montana 
31. Arkansas
32. Missouri
33. Indiana
34. West Virginia
35. Tennessee
36. Kansas
37. Idaho
38. Nevada
39. Wyoming
40. Arizona
41. Alaska 
T-41. Florida 
43. North Carolina 
44. Mississippi 
45. Alabama
T-45. Oklahoma
47. Georgia

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