The Journal Gazette
Wednesday, June 12, 2019 1:00 am

State's health care improves minimally

BRIAN FRANCISCO | The Journal Gazette

Indiana's health care system apparently is improved from a year ago, although not by much.

The Hoosier State ranks 36th nationally in the 2019 Scorecard on State Health System Performance released Tuesday by The Commonwealth Foundation, which advocates for affordable and accessible health care. Indiana was 37th in 2018 after placing 43rd and 44th in previous years' scorecards.

In the foundation's latest tabulations, Indiana performed slightly better than the national average for avoidable hospital visits, but it did far worse than the nation in four other categories: health care access and affordability; disease prevention and treatment; healthy lifestyles; and income-based health care disparities.

Broken down further, The Commonwealth Fund found that Indiana boosted its performance on 15 health indicators, saw little or no change on 21 indicators and regressed on nine indicators.

Indiana's best showings were for children's physical and mental health care and for hospital patient satisfaction. Its poorest results were for adult cancer screenings, adult smoking and meeting the needs of adults with mental illness.

Indiana's 36th-place ranking is last in its group of five Great Lakes states. Wisconsin ranks 12th; Michigan, 25th; Illinois, 28th; and Ohio, 33rd.

David Radley, senior scientist for the Commonwealth Fund in New York City, said Indiana health officials might consider studying Wisconsin's policies and practices for ideas to upgrade the Hoosier system. 

“We want people within states to be able to compare to their neighbors that may be more similar in terms of socioeconomic characteristics, political characteristics. ... For example, it may not always feel like a natural comparison to force a comparison between Mississippi and Massachusetts; the states have very different circumstances,” Radley said during a conference call with news media.

The top performers in the foundation's scorecard were, in order, Hawaii, Massachusetts, Minnesota, Washington, Connecticut and Vermont. The bottom performers were, in order, Arkansas, Nevada, Texas, Oklahoma and Mississippi.

The Commonwealth Foundation's main conclusions from its data were:

• Rising death rates from drugs, alcohol and suicide are “a national crisis,” although geographic trends are far from uniform. Eastern states have been harder hit by the opioid epidemic, while Western states suffer more deaths from suicide and alcohol.

Drug poisoning deaths increased by 115% nationally and by 200% in Indiana between 2005 and 2017. Alcohol deaths rose in that time by 37% nationally and by 96% in Indiana, and suicide deaths climbed by 28% nationally and by 38% in Indiana.

• The Affordable Care Act and state Medicaid expansions have reduced the rates of uninsured Americans, “but gains have stalled, and in some states have begun to erode,” the foundation reported.

• Increased health care costs are driving up employee spending on employer-provided health insurance.

“There are policy tools that states and the federal government could use to address these problems,” Radley said.

He noted that 17 states have yet to expand their Medicaid programs for low-income residents under the Affordable Care Act. Indiana is among those that have.

Radley said some state governments are looking at reducing medical costs for public employee insurance plans by insisting that provider prices are more in line with those for recipients of Medicare, the federal insurance program for people older than 65. 

“Ultimately improvement will require that states and the federal government work together to coordinate efforts and resources to ensure that whatever progress is made is sustainable,” he said.


Here is how Indiana stacks up on selected data from The Commonwealth Foundation's 2019 Scorecard on State Health System Performance:

Indiana U.S.
Adults who smoke
22% 16%
Adults who are obese
34% 31%
Drug deaths per 100,000
29.4 21.7
Suicide deaths per 100,000
6.31 4.0
Infant mortality (per 1,000)
7.4 5.9

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