Which states have the best, worst health care?

With the average American spending nearly $13,500 per year on health care, the personal-finance website WalletHub released its report on the States With the Best & Worst Health Care in 2024, as well as expert commentary, to identify where Americans receive the highest-quality services at the best prices.

WalletHub compared the 50 states and the District of Columbia across 44 key measures of healthcare cost, accessibility and outcomes. The data set ranges from the average monthly insurance premium to physicians per capita to the share of the population with health insurance.

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Best vs. Worst

• New Hampshire has the lowest average monthly health-insurance premium, which is 2.5 times lower than in West Virginia, the highest. 
   
• California has the highest retention rate for medical residents, which is 4.5 times higher than in the District of Columbia, the lowest. 
   
• North Dakota has the lowest number of infant mortalities (per 1,000 live births), which is 3.4 times lower than in Mississippi, the highest. 
   
• West Virginia has the lowest share of at-risk adults without a routine doctor visit in the past two years, which is 1.9 times lower than in New Mexico, the highest.

To view the full report and your state or the District’s rank, please visit here.
 

WalletHub also released the following commentary on the findings:

“Health care has two crucial components, cost and quality. The best health care in the nation isn’t helpful if it bankrupts the people who try to get it, and cheap health care isn’t worth paying for if it provides subpar or ineffective treatment. Therefore, the best states for health care are those that make high-quality care affordable, on top of providing many options for doctors and making insurance easily accessible.”

“Minnesota is the best state for health care, boasting the highest number of convenient care clinics per capita. In addition, Minnesota has the fourth-lowest average out-of-pocket medical spending and sixth-lowest average monthly insurance premium. To top things off, Minnesota has one of the best public hospital systems in the country, and residents have a long average life expectancy.”

--Cassandra Happe, WalletHub analyst  


What tips do you have for a person looking to find the right balance between the cost of premium and level of coverage?

“Most economists tend to choose health insurance plans with lower premiums and higher deductibles. The reason is that most health insurance plans with low deductibles have premiums that are set "too high." For example, a recent analysis of Kaiser Family Foundation data found that for firms offering both a high-deductible and lower-deductible health plan, 62 percent of the time the high-deductible option actually had less maximum spending risk. For roughly half of the firms in the data, the high-deductible plan was unambiguously the best option for employees. The advice I've developed over the years is to tell people to simply choose the high-deductible plan with the lower monthly premium and set aside the savings each month (i.e., the savings you are generating by not paying the higher monthly premium for the low-deductible plan) and put it into a health savings account or any other type of savings account so that you make sure that you will always have the savings you need to cover your deductible in the event of an illness or injury. As long as you commit to the savings plan, you will always come out ahead financially and you'll avoid overpaying for health insurance each month.”
 

--Matthew Notowidigdo, professor and Public Policy Fellow, University of Chicago
 
“Health insurance costs encompass premiums and out-of-pocket (OOP) expenses. OOP expenses consist of two components: deductibles (including copays) and coinsurance. Coinsurance represents the portion of medical expenses the policyholder is responsible for paying after meeting the deductible. For instance, in an 80/20 plan, the insurer covers 80% (the policyholder pays 20%) of the medical costs after the deductible is paid. All else being equal, health insurance plans with higher out-of-pocket (OOP) costs and lower coverage generally have lower premiums, and vice versa. Healthy individuals may find it advantageous to select a plan with lower coverage to reduce their premium costs. Conversely, individuals who anticipate higher medical expenses might benefit from choosing a plan with more extensive coverage to minimize their out-of-pocket costs.”

--Charles Yang, professor, Florida Atlantic University

[Read more:  Which are the worst states for mental health care?

What are the most important steps Americans can take to minimize health-related expenditures?

“The easiest way is to be healthy! If only it were that easy. Try to avoid behaviors that increase morbidity and mortality in excess (smoking, drinking, etc.), eat healthily (omega-3 and legumes), exercise regularly (gardening, walking, triathlons, etc.), and be social. There is nothing shocking there, we know this. What is best in those categories is going to be on an individual basis. It is something to determine with your primary care physician. Have a primary care physician whom you trust and can discuss the way you can best take control of your health to have a positive and lasting impact. This relationship will also be a great benefit when the unexpected happens, as they will be at the center of your care, treating you and providing referrals. Always ask for an itemized bill from the hospital and do not be afraid to push back on being charged ridiculous prices for ‘emotional support’ or band-aids."

--Michael French, practitioner in residence, University of New Haven
 
“Addressing the rising costs of medical care is a significant challenge. Lowering medical expenses requires collaboration among all stakeholders, including consumers of medical services, insurers, regulators, and policymakers. To reduce healthcare costs, consumers are encouraged to maintain good health, explore more affordable treatment options, and avoid unnecessary medical services. The moral hazard in health insurance leads to increased use and provision of unnecessary medical services. In addition to consumers, insurers, regulators, and policymakers must collaborate to enhance care management processes. Moreover, there is a need to establish a stricter and more comprehensive anti-fraud system to combat healthcare fraud, including instances of insurance exaggerations.”

--Charles Yang