New York has a better-than-average health care system, and in the past two years has successfully reduced its number of uninsured residents, according to a new report.
But the state fares poorly on other measures, such as avoidable hospital use and costs.
“We’re above average, but there’s certainly room for improvement,” said Courtney Burke, director of the New York State Health Policy Research Center at the Rockefeller Institute in Albany. “New York has made notable strides in improving its rate of people who are insured. Where we need to improve is preventable hospitalizations and hospital readmissions.”
The report, titled “Aiming Higher: Results from a State Scorecard on Health System Performance,” was released by The Commonwealth Fund, a New York City-based foundation that supports better access to health care, improved quality and greater efficiency.
Overall, the report shows gaps among states in access to health care, prevention, avoidable hospital use and costs. But it also paints a picture “of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs.
Overall, New York was ranked in the second quartile, at number 21, below Michigan and ahead of Virginia.
Top-ranked states include Vermont, Hawaii, Iowa, Minnesota, Maine and New Hampshire.
States in the bottom quartile included Tennessee, Alabama, Florida, Kentucky and Texas. In these states, the rates of uninsured are double those in the top quartile, and mortality from conditions that could be treated is 50 percent higher.
The report noted that New York has made a concerted effort to improve its performance since a 2007 Commonwealth Fund report assessed state health care systems. The state was ranked 18th for access to health care; 22nd for prevention and treatment; 50th for avoidable hospital use and costs; 11th for equity, a measure of how well a state’s health care system performs for its most vulnerable residents; and 17th for healthy lives, a measure of policies and programs that curb smoking, obesity and promote healthy lifestyles.
The only state that fared worse than New York for avoidable hospital use and costs was Louisiana.
price goes up
According to the report, all states have experienced substantial increases in costs of care, but there was substantial variation in per-person spending across the states. Average employer-sponsored health insurance premiums increased more than 4.5 percent in about half the states. States with high readmission rates also had high rates of Medicare spending.
This is the second such report released by The Commonwealth Fund.
These findings include:
u The quality of hospital care for heart attack, heart failure, pneumonia and the prevention of surgical complications improved dramatically. This reflects the impact of national efforts by Medicare to measure performance.
u In most states, symptoms of poor care coordination and continued inefficiency in the use of resources are evident in the increasing rates of hospital readmissions. In most states, there have been increases in hospital admissions and readmissions from nursing homes, as well as hospital readmissions for home health care patients. “These indicators point to a lack of incentives for effective transitional care and care management.”
u Rising costs are making care and coverage less affordable for a growing share of families, as insurance premiums are rising faster than middle-class family incomes.
One positive finding was that overall health coverage for children has improved. Since the beginning of the decade, insurance coverage in most states has been eroding for adults while increasing or holding steady for children, largely because the federal government has expanded coverage for children through the Children’s Health Insurance Program Fund.