Treading water on health care.

• Author: King, Martha
• Position: STATESTATS - Statistical table

State health care systems improved in some areas from 2007 to 2012--hospital readmissions declined and childhood immunization rates went up, for example. But overall, states showed little or no progress in cutting costs, increasing efficiency or coordinating care, according to a recent report by The Commonwealth Fund, a nonpartisan foundation that supports research on health and social issues.

The number of Americans with access to primary health care fell in half the states and more people delayed getting treatment, according to the report. People who seek care in emergency rooms as a last resort drive up costs.

Researchers looked at 42 health indicators over the five years, which included the Great Recession and preceded the coverage expansion and other reforms of the Affordable Care Act, including the rates of obesity, adult smoking, breast cancer deaths and infant mortality, along with areas such as the number of adults who went without care because of the cost and number of nursing home residents with pressure sores.

"More often than not, states exhibited little or no improvement. Access to care deteriorated for adults, while costs increased," the report says.

With health care consuming, on average, 30 percent of state budgets (the bulk for Medicaid and state employees), legislators take keen interest in finding ways to strengthen the system to accommodate more people, including creating payment models that support primary care and the medical home model of care. The latest Scorecard report indicates they have their work cut out for them.

State Health Systems

How states ranked on 42 measures of the availability, quality, costs and results of their health care systems, between 2007 and 2012

Room for Improvement How States Did on Specific Measurements of Health States' performances in specific areas of health care varied tremendously. Only a few states stood out for improving on several measures while declining on only a few: Colorado improved on 16 measures and declined on only six: Maryland improved on 14 and declined on four...