Top 61 health system markets

Healthcare in the U.S. improved between 2011 and 2014, when the Affordable Care Act was implemented, according to the 2016 edition of The Commonwealth Fund's Scorecard on Local Health System Performance. However, widespread differences in health outcomes persist between different geographic areas.

The Commonwealth Fund's scorecard assesses the state of healthcare in 306 U.S. regional healthcare markets, known as "hospital referral regions." It uses three dozen indicators grouped into four main dimensions, including access and affordability of care; prevention and treatment; potentially avoidable hospital use and cost; and health behaviors and outcomes.

The scorecard largely attributes the improvements to higher rates of insurance coverage under the ACA, the provision of higher quality care and fewer hospital readmissions. Overall, healthcare improved more than it worsened in 302 of the 306 assessed hospital referral regions, according to the 2016 scorecard.

Below are the 61 top performing hospital referral regions ranked by overall performance. These markets comprise the first quintile of the ranking, with the second quintile beginning at No. 62.

No. 1 — Honolulu

No. 2 — St. Paul, Minn.

No. 3 — San Mateo County, Calif.

No. 4 — Rochester, Minn.

No. 5 — Appleton, Wis.

No. 6 — St. Cloud, Minn.

No. 7 — San Jose, Calif.

No. 7 — San Francisco

No. 9 — Minneapolis

No. 10 — Dubuque, Iowa

No. 11 — Cedar Rapids, Iowa

No. 12 — Boulder, Colo.

No. 13 — Madison, Wis.

No. 14 — San Luis Obispo, Calif.

No. 15 — La Crosse, Wis.

No. 16 — Seattle

No. 17 — Contra Costa County, Calif.

No. 18 — York, Pa.

No. 19 — Green Bay, Wis.

No. 20 — Providence, R.I.

No. 21 — Alameda County, Calif.

No. 22 — Lebanon, N.H.

No. 23 — Santa Rosa, Calif.

No. 24 — Mason City, Iowa

No. 25 — Fort Collins, Colo.

No. 26 — Boston

No. 27 — Iowa City, Iowa

No. 28 — Worcester, Mass.

No. 29 — Arlington, Va.

No. 30 — Sioux Falls, S.D.

No. 30 — Rochester, N.Y.

No. 32 — Des Moines, Iowa

No. 33 — Fargo/Moorhead, Minn./N.D

No. 34 — Santa Barbara, Calif.

No. 34 — Morristown, N.J.

No. 34 — Traverse City, Mich.

No. 34 — Neenah, Wis.

No. 38 — Wausau, Wis.

No. 39 — Hinsdale, Ill.

No. 40 — Manchester, N.H.

No. 40 — Portland, Maine

No. 42 — Ogden, Utah

No. 43 — Hartford, Conn.

No. 44 — Duluth, Minn.

No. 45 — Albany, N.Y.

No. 46 — Everett, Wash.

No. 47 — Takoma Park, Md.

No. 48 — Springfield, Mass.

No. 49 — Marshfield, Wis.

No. 50 — Lincoln, Neb.

No. 50 — Denver

No. 52 — Grand Rapids, Mich.

No. 53 — Marquette, Mich.

No. 54 — Sacramento, Calif.

No. 54 — Sioux City, Iowa

No. 56 — Waterloo, Iowa

No. 57 — Bismarck, N.D.

No. 58 — Santa Cruz, Calif.

No. 59 — Syracuse, N.Y.

No. 60 — Lancaster, Pa.

No. 61 — Orange County, Calif.

For more information on the scorecard methodology, click here.

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