A nonprofit publication of the Kentucky Center for Public Service Journalism

Latest Commonwealth Fund health scorecard finds KY in bottom fifth of states again, but improving


By Melissa Patrick
Kentucky Health News

Kentucky’s ranking among the states rose from 46th to 42nd in the latest Commonwealth Fund Scorecard on State Health System Performance, partly because it had fewer adults who lack health insurance or went without health care because of cost.

The scorecard evaluates states on more than 40 indicators in five areas: care access and affordability; prevention and treatment; avoidable hospital use and hospital cost; health outcomes; and health equity.

Click to enlarge

Since 2016, Kentucky improved on 15 indicators and worsened on five. Only eight states improved on more health indicators than Kentucky.

The report notes that states that expanded Medicaid to people who earn up to 138 of the federal poverty level, which Kentucky did in 2014, saw greater improvements, on average, than states that did not.

The Commonwealth Fund has issued a state scorecard since 2013, but it says this year’s version uses different indicators and methods so it’s not directly comparable to previous ones. That said, Kentucky has been in the bottom fifth of states in each of the reports.

Kentucky’s top rankings were in access, affordability, prevention and treatment (30th). It remained near the bottom for avoidable hospital use and cost (47th), health outcomes (48th) and health equity (41st). The latter ranking largely reflects wide disparities between rich and poor Kentuckians.

The report also estimated what would happen if the state improved to the level of the best-performing state, which this year was Hawaii.

It said, among a long list of other improvements, that if this were to happen: 77,109 more Kentucky adults would be insured, 167,087 fewer Kentucky adults would go without needed health care because of cost and the state would have nearly 535,000 fewer smokers, which causes many of the health problems that plague our state.

Click here for an interactive map.

Among the state’s top indicators, the report found Kentucky ranked fifth for its low percentage of home-health patients who did not get better at walking or moving around; fifth for the low percentage of children without health insurance; and sixth for the low number of diabetic adults with employer-sponsored insurance who did not get an annual blood test for hemoglobin A1C, an indicator of diabetes.

At the bottom of the rankings, Kentucky ranked 51st for its high percentage of hospital admissions for ambulatory care-sensitive conditions among very poor adults who are eligible for both Medicare and Medicaid; 48th for its large percentage of adults who smoke, 50th for the large share of adults who report fair or poor health, and 49th for the high percentage of adults who have lost six or more teeth.

The state’s most improved indicators included the percentage of uninsured adults, which moved from 21 percent in the 2013 baseline performance to 7 percent; adults who went without care because of cost, improving from 19 percent to 12 percent; and home-health patients who did not get better at walking or moving around, which improved from 36 percent to 25 percent.

The indicators that worsened the most in Kentucky were hospital 30-day mortality, which increased from 13.3 percent in 2013 to 14.4 percent; adults with any mental illness reporting unmet needs, increasing from 19 percent to 23 percent; and deaths from suicide, alcohol and drug use per 100,000 people, up from 48.9 to 61.7, known as “deaths of despair.” The national rate for such deaths was 43.2 per 100,000.


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