Rising to the Challenge: Local Health System Performance Scorecard

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July 10th, 2012

health system performanceThe Commonwealth Fund released the first scorecard on Local Health System Performance which uses comparative data to score and compare the performance of health care systems across the United States.  This scorecard report tracks 43 indicators, including healthcare access, prevention and treatment, costs and potentially avoidable hospital use, and health outcomes.

According to their findings, where a person lives heavily affects their level of access and quality of care.  The geographic areas with the highest scores are found in the Upper Midwest and Northeast. The areas with the lowest performance were concentrated in the South, particularly within the Gulf Coast and south-central states.


Some of their key findings include:

  • Where people live influences their ability to access care as well as the quality of care they receive.
  • There are strong geographic patterns of performance, though the patterns vary by dimension.
  • There is dramatic variation in many performance indicators among local areas in the same state.
  • Spending among commercially insured and Medicare populations varies considerably across local areas.
  • Leading local areas often perform consistently well on multiple indicators across dimensions of performance.
  • Multiple dimensions of health system performance are interrelated.
  • Health system performance in the nation’s largest cities is highly variable.
  • Socioeconomic factors, particularly high poverty rates, are associated with some aspects of health system performance, but not all.
  • There is room for improvement in all local areas.

The recently upheld Affordable Care Act aims to improve local health system performance by reducing the number of uninsured, providing better access to care, as well as giving state legislation the ability to improve performance through expanded state-level policies.  Other new initiatives, such as the Center for Medicare and Medicaid Innovation, will serve as a resource for the task of improving our healthcare system. This Local Scorecard is a valuable resource that provides the first set of performance indicators, on which realistic goals can be set.  For more in depth information found in this report, visit The Commonwealth Fund's Local Score Card.