10 States With the Best Health Care Systems in America

How healthy are our health care systems? While some states appear to be doing well, others seem to be in need of some serious TLC.

The Commonwealth Fund, a New York City-based private foundation whose mission is to “promote a high-performing, equitable health care system,” ranked all 50 states in its latest annual Scorecard on State Health System Performance.

The report uses 58 measures to develop its state-by-state rankings in categories such as access and affordability (which includes rates of insurance coverage, out-of-pocket expenses and cost-related barriers to care) and prevention and treatment (which includes getting preventive care such as COVID-19 vaccines and quality of care in hospital, ambulatory and long-term care settings).

Following is a look at the states with the best overall health care systems.

New York

This state’s:

Overall health care system ranking: 9 (tie)

Ranking for health care access and affordability: 13

Ranking for preventive health care and treatment: 28

In an effort to mitigate a health care worker shortage, Gov. Kathy Hochul signed a bill into law that would allow nurses to complete one third of their clinical training through simulation experiences. New York City Mayor Eric Adams also signed legislation to enable New Yorkers to compare costs hospitals are charging for the same services.

Pennsylvania

This state’s:

Overall health care system ranking: 9 (tie)

Ranking for health care access and affordability: 9

Ranking for preventive health care and treatment: 13

The Keystone State enjoyed the biggest ranking boost of any state from 2019 to 2021, moving up six spots, according to The Commonwealth Fund. However, despite its top 10 ranking, many of the state’s hospitals “continue to face serious financial challenges,” according to the Pennsylvania Health Care Cost Containment Council.

Maryland

This state’s:

Overall health care system ranking: 8

Ranking for health care access and affordability: 14

Ranking for preventive health care and treatment: 10

The Old Line State rose four spots in The Commonwealth Fund’s rankings between 2019 and 2021. In an attempt to further improve health care access and support, Gov. Wes Moore recently announced new Medicaid benefits to expand pregnancy care coverage and bolster violence prevention.

Washington

This state’s:

Overall health care system ranking: 7

Ranking for health care access and affordability: 10

Ranking for preventive health care and treatment: 20

To illustrate the socioeconomic disparities in health care in the state, the Washington Health Alliance combined health care cost data with the University of Wisconsin’s Neighborhood Atlas and revealed that “where someone lives can impact the cost of caring for them.”

Connecticut

This state’s:

Overall health care system ranking: 6

Ranking for health care access and affordability: 8

Ranking for preventive health care and treatment: 7

Despite its high ranking, The Constitution State worsened on more metrics than it improved on — from third overall, fourth in access and affordability, and 31st in avoidable hospital use and cost in 2022 to No. 6, No. 8 and No. 40 in those categories in 2023. To improve this situation, Gov. Ned Lamont recently signed legislation to reduce costs and improve delivery of care.

Vermont

This state’s:

Overall health care system ranking: 5

Ranking for health care access and affordability: 5

Ranking for preventive health care and treatment: 4

The Green Mountain State maintained its spot from where it ranked overall in 2022. However, dark clouds may be looming on the horizon for the state’s 14 community hospitals, which had an operating deficit of $62 million in 2022.

Rhode Island

This state’s:

Overall health care system ranking: 4

Ranking for health care access and affordability: 3

Ranking for preventive health care and treatment: 3

Thanks to an innovative program, many women and minority paraprofessionals will be able to continue their education to become licensed health professionals in the Ocean State and thereby increase racial and linguistic diversity in the health care workforce. The Health Professional Equity Initiative will pay for postsecondary education and assist with childcare and transportation costs, among other items.

New Hampshire

This state’s:

Overall health care system ranking: 3

Ranking for health care access and affordability: 4

Ranking for preventive health care and treatment: 1

The Granite State rose to No. 3 from its No. 8 spot in 2022, including higher placings in both the Access & Affordability and Prevention & Treatment categories. Thanks to the state’s Medicaid expansion, the number of residents without health care coverage dropped 42% in the five years following implementation of the program in 2014.

Hawaii

This state’s:

Overall health care system ranking: 2

Ranking for health care access and affordability: 2

Ranking for preventive health care and treatment: 26

Gov. Josh Green bolstered health care access in the Aloha State by signing legislation in June to authorize construction of a West Maui hospital and set aside funds and student aid for prospective nurses. Hawaii also will allow doctors in other states to more easily practice in the island state.

Massachusetts

This state’s:

Overall health care system ranking: 1

Ranking for health care access and affordability: 1

Ranking for preventive health care and treatment: 1

The Bay State was No. 1 in six of eight categories by The Commonwealth Fund, but those rankings come at a high cost. Regulators sounded the alarm in June, noting that health care prices are outpacing the national average and that health insurance premium costs have increased more than three times as much as household income since 2000.