Appendix 1. Sociodemographic Characteristics for the Top and Bottom 10 States in the 2009 State Scorecard on Health System Performance

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1 Appendix 1. Sociodemographic Characteristics for the Top and Bottom 10 States in the 2009 State Scorecard on Health System Performance Resident Population in Millions (a) Median Annual Household Income (b) Percent of Population with Incomes Below 100% of Federal Poverty Level (c) Percent of Population with Incomes at or Below 250% of Federal Poverty Level (c) Percent of Population That Is Black (d) Percent of Population That Is Hispanic (d) Percent of Population That Is "Other" Nonwhite Race/Ethnicity (d) United States $49, Top 10 States Avg. 2.9 $56, Connecticut 3.4 $65, Hawaii 1.2 $61, NSD Iowa 3.0 $50, Maine 1.3 $48, Massachusetts 6.4 $59, Minnesota 5.1 $56, New Hampshire 1.3 $66, North Dakota 0.6 $49, NSD Vermont 0.6 $50, Wisconsin 5.5 $51, Bottom 10 States Avg. 7.7 $44, Arkansas 2.8 $39, Florida 18.0 $45, Illinois 12.7 $53, Kentucky 4.2 $41, Louisiana 4.3 $42, Mississippi 2.9 $36, Nevada 2.6 $53, New Mexico 2.0 $43, Oklahoma 3.5 $45, Texas 23.9 $47, NSD = Not sufficient data. (a) Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the U.S. Census Bureau, Current Population Survey ASEC Supplements. Assembled by The Kaiser Family Foundation, statehealthfacts.org. (b) U.S. Census Bureau, Current Population Survey ASEC Supplements. Income of Households by State Using 3-Year-Average Medians available at Assembled by The Kaiser Family Foundation, statehealthfacts.org. (c ) Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the U.S. Census Bureau, Current Population Survey ASEC Supplements. Assembled by The Kaiser Family Foundation, statehealthfacts.org. The grouping used for analysis is the health insurance unit (HIU), which groups individuals according to their insurance eligibility, rather than by relatedness or household. (d) Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the U.S. Census Bureau, Current Population Survey ASEC Supplements. Assembled by The Kaiser Family Foundation, statehealthfacts.org. "Other" includes Asian Americans, Pacific Islanders, American Indians, Aleutians, Eskimos and persons of "Two or More Races."

2 Appendix 2. Health Characteristics for the Top and Bottom 10 States in the 2009 State Scorecard on Health System Performance Invasive Cancer Incidence Age- Adjusted Rate per 100,000 (a) Percent of Adults Who Are Overweight or Obese (b) Adult Self-Reported Current Asthma Prevalence Rate (b) Percent of Adults Ever Told by a Doctor That They Have Diabetes (b) United States Top 10 States Avg Connecticut Hawaii Iowa Maine Massachusetts Minnesota New Hampshire North Dakota Vermont Wisconsin NA Bottom 10 States Avg Arkansas Florida Illinois Kentucky Louisiana Mississippi Nevada New Mexico Oklahoma Texas (a) U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2006 Incidence and Mortality Web-based Report. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; Available at Assembled by The Kaiser Family Foundation, statehealthfacts.org. (b) Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System Survey Data. Assembled by The Kaiser Family Foundation, statehealthfacts.org.

3 Appendix 3. Health Care Market Characteristics for the Top and Bottom 10 States in the Percent of Community Hospitals Percent of Community Hospitals That Are Nonprofit or Owned by Owned by or Contracted to Highly State/Local Government (a) Integrated Systems (b) Percent of Certified Nursing Facilities That Are Nonprofit or Owned by State/Local Government (c) HMO penetration rate (d) United States Top 10 States Avg Connecticut Hawaii Iowa Maine Massachusetts Minnesota New Hampshire North Dakota Vermont Wisconsin Bottom 10 States Avg Arkansas Florida Illinois Kentucky Louisiana Mississippi Nevada New Mexico Oklahoma Texas (a) AHA Annual Survey Copyright 2010 by Health Forum LLC, an affiliate of the American Hospital Association, special data request. Assembled by The Kaiser Family Foundation, statehealthfacts.org (b) SDI data reported in the Sanofi Aventis Managed Care Digest Series, Hospital/Systems Digest, Highly integrated health care systems either own or contract with at least three components of health care delivery, including at least one acute-care hospital, at least one physician component, and at least one other component of care. Highly integrated health care systems also have at least one systemwide contract with a payer, such as an HMO. Hospitals include short-term, acute-care, nonfederal hospitals in the SDI database. (c) C. Harrington, H. Carrillo, and B. Blank. Table 7, "Nursing, Facilities, Staffing, Residents, and Facility Deficiencies, 2001 Through 2008," Department of Social and Behavioral Sciences, University of California, San Francisco, accessed November Available at Assembled by The Kaiser Family Foundation, statehealthfacts.org (d) Healthleaders, Inc., Special Data Request, April 2010, Assembled by the Kaiser Family Foundation, statehealthfacts.org.

4 Appendix 4. Performance on Access Dimension and Indicators for the Top and Bottom 10 States in the Access Rank Percent Nonelderly Adults (Ages 18 64) Insured Percent Children (Ages 0 17) Insured Percent At-Risk Adults Visited Doctor for Routine Checkup in Past Two Years Percent Adults Without Time When Could Not See Doctor Because of Cost United States Top 10 States Avg Connecticut Hawaii Iowa Maine Massachusetts Minnesota New Hampshire North Dakota Vermont Wisconsin Bottom 10 States Avg Arkansas Florida Illinois Kentucky Louisiana Mississippi Nevada New Mexico Oklahoma Texas

5 Appendix 5. Performance on Prevention and Treatment Dimension and Indicators for the Top and Bottom 10 States in the Percent Adults Age 50+ Received Recommended Prevention & Treatment Rank Preventive Care Percent Adult Diabetics Received Recommended Preventive Care Percent Children Ages Months Received Five Vaccines Percent Children with Medical and Dental Preventive Care Visits Percent Children Received Needed Mental Health Care Percent Hospitalized Patients Received Recommended Care for Heart Attack, Heart Failure, and Pneumonia Percent Surgical Patients Received Appropriate Care to Prevent Complications Percent Home Health Patients Better at Walking or Moving Around Percent Adults with a Usual Source of Care Percent Children with a Medical Home Percent Heart Failure Patients Given Instructions at Discharge Percent Medicare Patients Experienced Good Communication with Provider Percent Medicare Patients Giving Best Rating for Care Received Percent High-Risk Nursing Home Residents with Pressure Sores Percent Long-Stay Nursing Home Residents Physically Restrained United States * * Top 10 States Avg Connecticut Hawaii Iowa Maine Massachusetts * Minnesota New Hampshire North Dakota Vermont Wisconsin Bottom 10 States Avg Arkansas Florida Illinois * * * Kentucky Louisiana Mississippi Nevada New Mexico Oklahoma Texas Percent Long-Stay Nursing Home Residents with Moderate to Severe Pain * Data not available.

6 Appendix 6. Performance on Avoidable Hospital Use and Costs Dimension and Indicators for the Top and Bottom 10 States in the Avoidable Hospital Use and Costs Rank Hospital Admissions for Pediatric Asthma per 100,000 Children Percent Adult Asthmatics with Emergency Room or Urgent Care Visit Medicare Admissions for ACS Conditions per 100,000 Beneficiaries Medicare 30-Day Hospital Readmission Rates Percent Long-Stay Nursing Home Residents with Hospital Admission Percent Short-Stay Nursing Home Residents with Readmission Within 30 Days Percent Home Health Patients with Hospital Admission Hospital Care Intensity Index, Chronically Ill Medicare Beneficiaries in Last Two Years of Life Total Single Health Insurance Premium per Enrolled Employee United States , $4,386 $8,304 Top 10 States Avg , ,565 7,197 Connecticut , ,740 8,972 Hawaii , * * ,831 5,311 Iowa , ,146 6,572 Maine 18 * * 5, ,910 6,952 Massachusetts , ,836 9,379 Minnesota , ,432 6,600 New Hampshire , ,247 7,814 North Dakota 4 * * 6, ,830 6,108 Vermont , ,900 7,284 Wisconsin , ,777 6,978 Bottom 10 States Avg ,155 8,434 Arkansas * 7, ,923 7,470 Florida * 5, ,517 9,379 Illinois * 7, ,643 8,457 Kentucky , ,009 8,260 Louisiana 51 * , ,055 9,401 Mississippi 45 * , ,124 7,855 Nevada * 4, ,927 8,714 New Mexico 10 * , ,074 6,803 Oklahoma 44 * , ,072 8,642 Texas , ,205 9,361 Total Medicare Reimbursements per Enrollee ACS=ambulatory care sensitive. * Data not available.

7 Appendix 7. Performance on Healthy Lives Dimension and Indicators for the Top and Bottom 10 States in the Healthy Lives Rank Mortality Amenable to Health Care, Deaths per 100,000 Population Infant Mortality, Deaths per 1,000 Live Births Breast Cancer Deaths per 100,000 Female Population Colorectal Cancer Deaths per 100,000 Population Suicide Deaths per 100,000 Population Percent Nonelderly Adults Limited in Activities Because of Physical, Mental, or Emotional Problems Percent Adults Who Smoke Percent Children Ages Who Are Overweight or Obese United States Top 10 States Avg Connecticut Hawaii Iowa Maine Massachusetts Minnesota New Hampshire North Dakota Vermont Wisconsin Bottom 10 States Avg Arkansas Florida Illinois Kentucky Louisiana Mississippi Nevada New Mexico Oklahoma Texas * Data not available.