Though both showed improvements, Kansas and Missouri continue to rank in the bottom half of states on measures of health care access, quality, costs and outcomes, according to a new report by the Commonwealth Fund.
Overall, Kansas tied for 28th among the 50 states and the District of Columbia, and Missouri ranked 36th. Kansas improved on 10 indicators and worsened on one while Missouri improved on nine and worsened on one.
The report, which was released Wednesday, looks at 42 health indicators broadly grouped under five categories: access and affordability, prevention and treatment, potentially avoidable hospital use and cost, and premature deaths and health risk behaviors such as smoking.
Overall, the report finds that states’ health care systems improved more than they declined since the Commonwealth Fund, a private foundation that focuses on health policy, last measured them in 2014. At the same time, it says that wide differences persist among the states.
One stark example of the latter: Uninsured rates for low-income working-age adults varied as much as six-fold. The lowest rate, 8 percent, was in Massachusetts; the highest, 46 percent, was in Texas.
Notably, states that expanded Medicaid by January 2014 saw the biggest declines in the uninsured rate for low-income adults, of 13 to 18 percentage points, according to the report. States that did not, including Kansas and Missouri, were among those with the lowest declines.
Kansas performed well in a handful of categories. Among them:
- Children with emotional, behavioral or developmental problems who received needed mental health care in the past year.
- Breast cancer deaths per 100,000 female population.
- Children age 19 to 35 months who received all recommended doses of seven key vaccines.
- Hospitalized patients who reported hospital staff always managed pain well, responded when needed help and explained medicines and their side effects.
One category that saw no improvement nationwide: African Americans were more likely to die early from a treatable condition in every single state.
“Potentially preventable death rates were higher for blacks than whites in all states, and in 11 states they were at least twice as high,” David C. Radley, one of the authors of the report, said Tuesday in a telephone conference call with reporters.
But Radley also noted that there was more than a two-fold spread in premature death rates among states’ white populations, with high rates in the south and south central states and lower rates clustering in the northeast and in states like Colorado, Minnesota, Utah and Washington.
The states that ranked at the top and the bottom of Commonwealth’s last scorecard remained the same. Minnesota, Vermont, Hawaii and Massachusetts took top honors, while Louisiana, Arkansas, Oklahoma and Mississippi remained at the bottom.