NE states rank high on scorecard report but still have areas needing improvement

By Susan Gonsalves
September 30th, 2023
David C. Radley, Ph.D., MPH, The Commonwealth Fund’s senior scientist for health system tracking.
David C. Radley, Ph.D., MPH, is The Commonwealth Fund’s senior scientist for health system tracking.

Massachusetts holds top spot

Massachusetts ranked first overall on The Commonwealth Fund’s “”Scorecard on State Health System Performance” report with New Hampshire, Rhode Island, Vermont, and Hawaii rounding out the top five.

Connecticut ranked sixth while Maine was 16th. The lowest performing states were Oklahoma, West Virginia, and Mississippi.

In its 12th year, The Commonwealth Fund’s rankings for health system performance are based on 58 measures of health care access, quality, use of services, costs, health disparities, reproductive care, women’s health care and women’s health, and health outcomes.

On the behavioral health front, nationwide, the data shows significant increases in the number of teens who persistently feel sad or who attempt or seriously consider suicide. And, on average, 60 percent of adolescents ages 12 to 17 who had a major depressive episode did not get any treatment.

“We want health care professionals to use this benchmarking report to identify opportunities to do a better job.” --David C. Radley, Ph.D., MPH, senior scientist for health system tracking, The Commonwealth Fund.

This data, although not surprising, is still alarming to David C. Radley, Ph.D., MPH, The Commonwealth Fund’s senior scientist for health system tracking.

“That really stood out…how poorly states scored in that measure,” Radley said, adding that the suicide rate nationwide has not decreased over the past 10 years and drug overdoses continue to rise.

“Even Massachusetts at number one is ranked 40th for adolescents with depression,” Radley pointed out. Rhode Island ranks 37th in this area.

“Across New England, there are opportunities to do better on mental health access for teens and adolescents,” he said.

New England states also score lower on avoidable hospital use and cost, with Connecticut in 40th and Massachusetts ranked 44th.

During the COVID-19 pandemic, temporary federal policies drove uninsured rates to record lows, with almost all states realizing gains in health coverage.

However, as these policies end, coupled with high costs, millions of Americans find themselves experiencing medical debt. And this debt is at the stage where it has often gone to collection agencies, Radley said.

Other key findings:

Fifty-five percent of adults with mental illness reported not receiving treatment. Among adults who did not receive care, 42 percent cited cost as the primary barrier.
Connecticut ranks 37th in this category.

Also, drug and alcohol deaths reached record levels in 2021.

In Maine, the number of drug overdose deaths ranked the state 43rd while Vermont and Connecticut both ranked 37th.

The number of suicide deaths put Vermont in 39th while Maine had a ranking of 35th.

New Hampshire was 27th for alcohol-related deaths while 29th is where Rhode Island landed.

“When you’ve been doing this over time, you start to see trends,” Radley said. “The results reinforce the fact that these problems have existed for a long time and we haven’t figured out a solution yet.”

The organization stated the nation could improve health outcomes and lessen variations state to state if federal and state governments close the gaps that remain and enroll uninsured people who are eligible for subsidized covered.

Other recommendations include improving the cost protections of insurance plans and lowering the barriers for behavioral health care as well as reproductive and preventive health.

Specific to behavioral health, suggestions include promoting the integration of primary and mental health care and ensuring reimbursements are adequate in small, rural and under resourced communities in particular.

A collaborative care model is also recommended in pediatric settings.

In addition to increasing access to addiction care, expanding harm reduction policies and providing supplies for safe drug use and supervised consumption sites is recommended.

Radley said he hopes professionals like psychologists can look at the data relevant to them and use it to see where they are doing well and where there are gaps in performance.

“We want health care professionals to use this benchmarking report to identify opportunities to do a better job,” Radley said.

The report contains measures for people in other professions as well.

“We want it to touch every aspect of the delivery system and public health,” he added.

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