National health scorecard shows Kentucky making improvements

Graph from The Commonwealth Fund Scorecard website

By Melissa Patrick
Kentucky Health News

Kentucky remains in the bottom fourth of a states' health ranking released Dec. 8, but it was one of the states that saw the greatest improvements of individual health indicators in the first year of full federal health reform.

The Commonwealth Fund Scorecard on State Health System Performance looks at five areas: medical-care access and affordability, prevention and treatment of disease, avoidable hospital use and hospital cost, health status and "health equity."

Kentucky ranked 40th overall, but improved on 13 indicators and worsened on only three. Louisiana, Oklahoma and Rhode Island were the only other states to improve on more indicators.

Kentucky's top rankings were in access and affordability (28th) and prevention and treatment (20th), but it remained near the bottom for avoidable use of hospitals and cost of care (49th), health status (44th) and equity (45th).

Although states such as Kentucky have a long way to go, "they also have more to gain from improvement," Douglas McCarthy, senior research director for The Commonwealth Fund, told Laura Ungar of The Courier-Journal.

Some measures in which Kentucky saw substantial improvement were:

• Adults who went without care because of cost in the previous year;
• Adults 50 and older who got recommended screenings and preventive care;
• High-risk nursing home residents with pressure sores;
• Readmissions to the hospital in 30 days among Medicare patients;
• Breast cancer deaths;
• Infant mortality
• The percentage of insured adults. David Radley, the senior scientist tracking health system improvement for The Commonwealth Fund, told Ungar that Kentucky led the nation in declines among uninsured adults. Other research has found likewise.

This year’s scorecard is the fourth in a series, and the first to measure the effects of the Affordable Care Act, looking at changes during 2013 and 2014 to assess the early effects of the law’s 2014 health insurance expansions. It also measures payment reforms and incentives to reduce re-admissions to the hospital.

"The effects of the ACA are not yet full reflected in the 2015 Scorecard results," says the report. "It may take many years to see the resulting changes."

Ungar writes, "Dr. David Blumenthal, president of The Commonwealth Fund, said he "can't with scientific precision" attribute all the gains in his organization's report to the ACA, but several positive trends do coincide with the implementation of the law."

Visit the U.S. Health System Data Center at datacenter.commonwealthfund.org for interactive maps, state profiles, and comparisons of state performance.