The Best and Worst States for Health Care

Access to health care services and the affordability of health insurance are crucial to overall health but vary widely across the United States. MoneyGeek analyzed a host of statistics, from health outcomes — such as deaths and rates of certain diseases or risk factors — to health access and cost — such as how many people are uninsured and have low-cost health insurance options available — to find the best and worst states for health care in 2024.

To evaluate health care in the United States, MoneyGeek looked at three categories of data that together create a comprehensive view of the overall quality of health care in each location. Those categories include:

• Health outcomes, including indicators such as rates of disease and risk factors like obesity and smoking, preventable deaths and infant mortality. These measures help answer the question: How healthy are the people who live here?

• Cost, including factors like how much the state spends on health care, the average cost of private health insurance, and the return on health care quality per 1% of state GDP spent. These measures help answer the questions: How expensive is health care in this state, and how effectively is state spending translating into quality care?

• Access, including data on the number of primary care providers and hospital beds available, how many people are uninsured and how many people needed care but had difficulty getting it. These indicators help answer the question: How easy is getting the health care you need in this state?

Within these three categories, we broke down the best and the worst states across various health care outcome, cost and access data points. Below is a summary of those findings and the best and worst states for each data point.

To explore and rank health care quality by state, MoneyGeek analyzed three core categories — health outcomes, cost and access to care — using health care data from the Kaiser Family Foundation, the Centers for Disease Control and HealthData.gov. We assigned weights to each factor within these core categories to measure health care quality. We used the 2023 data for New York's average private annual health insurance premiums due to the unavailability of 2024 data.

MoneyGeek used the following metrics in our analysis:

• Mortality rate: Full weight
• Infant mortality rate: Full weight
• Life expectancy: Half weight
• Diabetes deaths per 100,000 people: Half weight
• Obesity as a percentage of the population: Half weight
• Hospital inpatient stays involving opioid-related diagnoses per 100,00 people: Quarter weight
• Smoking rate among adults: Quarter weight
• Suicide deaths among persons ages 12 and older per 100,000 people: Quarter weight
• New HIV cases among persons ages 13 and older per 100,000 people: Quarter weight
• Annual health insurance costs: Double weight
• Average Performance Score Per one percent of GDP Spent: Full weight
• Health care spending as a percentage of state GDP: Half weight
• Health care spending as a share of GDP per resident: Half weight
• Percentage of population with health insurance: Full weight
• Number of hospital beds per 100,000 people: Half weight
• Adults who had a doctor's office or clinic visit in the last 12 months and needed care, tests, or treatment who sometimes or never found it easy to get the care, tests, or treatment, Medicare fee-for-service: Quarter weight
• Adults who needed to see a specialist in the last six or 12 months who sometimes or never found it easy to see a specialist, Medicare fee-for-service: Quarter weight
• Primary care health professional shortage areas: % of need met to remove shortage designation: Quarter weight
• Number of primary care providers per 100,000 population: Quarter weight

The data points presented are defined as follows:

Rank: Based on the “Final Score” ranging from 1-100

Final Score: Cumulative total of Outcome, Cost and Access scores

1. Outcome Factor Rank: Based on cumulative scores across the following factors:
   • Infant mortality rate: The number of infant deaths per 1,000 live births
   • Preventable death rate: Deaths that can be avoided through effective preventative health care and interventions per 100,000 residents
   • Diabetes mortality rate: Deaths attributed to diabetes per 100,000 residents
   • Obesity: Percentage of population considered obese
   • Smoking rate: Percentage of adults who reported smoking
   • Life expectancy: The average number of years a person can expect to live
   • Suicide rates: Suicide deaths among persons age 12 and over per 100,000 residents
   • New HIV cases per 100,000 residents over the age of 13
   • Opioid-related hospital stay rate: Inpatient hospital stays involving opioid-related diagnoses per 100,000 residents
2. Cost Factor Rank: Based on cumulative scores across the following factors:
   • Health care spending as a percentage of state GDP: Government spending on health care and social assistance out of total state GDP
   • State government spending on health care and social assistance per resident
   • Average annual private health insurance premium costs
   • Quality of Care Per 1% of GDP Spent: Calculated by dividing the quality of care score by health care spending as a percentage of the state’s GDP. The quality score is based on AHRQ, which grades health care quality across several health measures in categories. We then converted these grades into a numeric scale and averaged these scores across the state.
3. Access Factor Rank: Based on cumulative score across the following factors:
   • Number of hospital beds per 1,000 residents
   • Number of primary care providers per 100,000 residents
   • Primary care provider shortage areas (HPSAs) by state: Designations that identify areas of the U.S. experiencing health care professional shortages
   • Percentage of population with access to any insurance versus just health insurance
   • Ease of access to care at the doctor’s office or clinic using Medicare
   • Ease of access to care at a specialist using Medicare