State Rankings

Hawaii, Massachusetts, Minnesota, Iowa, and Connecticut are the top-ranked states according to the 2020 Scorecard, which assesses all 50 states and the District of Columbia on more than 45 measures of access to health care, quality of care, service use and costs of care, health outcomes, and income-based health care disparities.

Which states moved up the most in the rankings between 2014 and 2018, and which states dropped?

The District of Columbia had the largest jump in rankings, up 13 spots. New York gained 10 spots in the rankings and New Jersey rose nine spots.

South Dakota fell 19 spots in the rankings, while Wyoming and Maine fell 12 and 17 spots, respectively.

Overall health system performance (prior to COVID-19)

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Note: States are arranged in rank order from left (best) to right (worst), based on their overall 2020 Scorecard rank. The 2020 Scorecard rank reflects data generally from 2018, prior to the COVID-19 pandemic.

States are arranged in rank order from top (best) to bottom (worst), based on their 2020 Scorecard rank.

What are the leading states by region?

  • Great Lakes
  • Mid-Atlantic
    New York
  • New England
  • Plains
  • Rocky Mountain
  • Southeast
  • Southwest
    New Mexico
  • West

State health system performance varies within regions

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Note: Regions are U.S. Census regions. Regional shading is based on performance among states within the region only. See Scorecard Methods for additional detail.

Which states improved on the most indicators?

Florida, Kentucky, Louisiana, and Virginia each improved on 17 of 43 indicators we track over time, although Louisiana had a larger net gain, having gotten worse on fewer indicators (seven indicators) than Florida and Virginia (12 indicators). Five states (Arizona, Arkansas, Mississippi, Missouri, and West Virginia) each improved on 16 indicators.

Fourteen states got worse on more indicators than they improved on.

More improvement than decline: Florida, Kentucky, Louisiana, and Virginia improved most, with gains on 17 indicators between 2014 and 2018, prior to COVID-19

Notes: Based on five-year trends for 43 of 49 total indicators (disparity dimension not included), generally reflecting 2014 to 2018, prior to COVID-19 pandemic; trend data are not available for all indicators. Bar length equals the total number of indicators with any improvement or worsening with an absolute value greater than 0.5 standard deviations (StDev) of the state distribution.