Vermont leads the nation in the delivery of its health care, while Mississippi is rated the worst, according to a non-partisan study that compares all 50 states and the District of Columbia.

Vermont, Hawaii, Iowa, Minnesota, Maine and New Hampshire ranked 1 to 5 in 38 indicators of health care.

At the bottom were Mississippi, along with Oklahoma, Louisiana, Arkansas, Nevada and Texas.

The Commonwealth Fund Commission’s “Scorecard on Health System Performance,” rated the states on access, quality, costs and health outcomes in a follow up to their 2007 report.

Overall, the states which did best on the Commonwealth scorecard were in New England and the upper Midwest, and the worst states were in the South.

Vermont, with only 640,000 residents, has nearly universal health care coverage with 93 percent insured. Its innovative “Blue Print for Health” focuses on prevention of chronic diseases.

“We’re small. There are 19 cities larger than the state of Vermont,” said Susan Besio, director for health care reform and Medicaid for Vermont.

“But I believe there is something unique about Vermont in terms of its culture,” she told ABCNews.com. “We want to take care of each other and we are a healthy state.”

In Mississippi, however, about 20 percent are uninsured despite having some of the highest rates of hypertension, diabetes and asthma.

According to the report, only 35.7 percent of adults 50 or over in Mississippi receive recommended screening and preventive care.

“When you compare Mississippi on almost any socio-economic profile, we are a struggling population that has a large percentage of low-income individuals, high unemployment rates, low rate of education,” said Robert Pugh, director of the Mississippi Primary Health Care Association.

The scorecard “paints a picture of health care systems under stress, with deteriorating health insurance coverage for adults and rising health care costs,” according to co-author Cathy Schoen, who is senior vice president of the commission.

“Where you live matters for access, quality of care and whether you live a long and healthy life. These wide and persistent gaps among states highlight the need for national reforms and federal action to support states.”

For example, 32 percent of working-age adults in Texas are uninsured, compared to only 7 percent in Massachusetts in the most recent survey.

“It’s very hard to have a high performing health care system and hospitals that do well for everyone if you have a high rate of uninsured in the state,” said Schoen.

In 1999-00, there were only two states with 23 percent or more of adults uninsured. But by 2007-2008 there were nine.

Children fared much better, due in large part to the Children’s Health Insurance Program (CHIP) under Medicaid. The number of states with 16 percent or more of children uninsured dropped from nine to three during the same time period.

Other findings of the report were that in a, costs rose and quality improved in areas where outcomes were reported to the public.

Vermont’s ‘Blue Print For Health’ A Model

The Green Mountain state was cited for its model “Blue Print” program. Launched by Republican Gov. Jim Douglas, it covers everything from teaching children healthy eating to helping seniors stay in their homes rather than going to costly nursing homes.

“You betcha, I feel good about the reforms we put in place,” Douglas told ABCNews.com. “It’s centered on quality and containing costs. Care shouldn’t start in the emergency room.”

All Vermonters are encouraged to have yearly exams and adults are notified when they are due for check-ups.

Douglas talks to children about “getting off the couch” and set an example just this week by joining elementary students on a walk to school.

With the second oldest population in the nation, Vermont subsizes care for seniors and the disabled to defray the costs of home care. Nursing home beds were reduced by 200 last year.

In one pilot program, electronic medical records can avert expensive tests like MRIs and x-rays. One emergency room doctor seeing a woman with stomach pains discovered in her online medication history that she had not filled her prescription for ulcer medicine.

“It takes time and so a lot of the fruits come from years of work and planning and cooperation,” said Douglas.

Health Care Affects a State’s Economy

But Mississippi, with the highest infant mortality and low birth rates in the nation, makes access to these Medicaid programs more difficult, according to Roy Mitchell, director of the Mississippi Health Advocacy Program (MHAP).

“I am not at all surprised we were 51st on the list,” he told ABCNews.com. “We are last on several health indicators. Our policy makers work hard at being last.”

Despite one of the highest matches of federal to state dollars in Medicaid funding, the state mandates “face-to-face” eligibility, requiring all new applicants and those reapplying for benefits to come in for an interview.

“As a direct result, 65,000 children have fallen off the rolls,” Mitchell said.

“Mississippi does virtually no outreach at all. They don’t publish where these face to face stations are and what times,” he said. “It’s a bureaucratic maze even to find out where to go. And when they get there they don’t have a certain document.”

Of those, about 77 percent would be eligible, he said. “It’s touted as fraud prevention.”

These disparities between the highest and lowest ranked states could be alleviated with national reform, according to Commonwealth.

The report emphasizes the need for insurance reform that rewards good outcomes, payment reform with an emphasis on prevention and advanced information systems that travel with the patient from physician to physician, saving time, money and preventing errors.

“What the scorecard is showing is that we have a system under stress, no matter where we live,” said co-author Schoen. “The costs are rising more than people’s incomes. We need to act.”

Schoen said she has hope for reform. “There is real leadership and people are taking reform seriously.”

Source: ABC News

Log on to Healthbase to learn about medical tourism or to get a FREE quote for any surgery in the United States or abroad.

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Medical Tourism is no longer restricted to outbound medical tourism i.e. Americans seeking care outside of the country. Domestic medical tourism is gathering pace as more and more Americans are now crossing state borders to take advantage of cheaper prices available for quality health care out-of-state. It’s amazing to know that the price differential on healthcare within the same country can be tremendous if only you take the trouble to shop for it.

Recently Healthbase partnered with many health care providers in several states within the United States. The prices on major procedures that these providers offer to Healthbase clients are as low as 10% of the prevailing cost of those procedures in other typical hospitals within the country. Read more about this partnership.

So how can some US providers offer such low rates?
Patients can avail of such low rates if they choose the one-pay option. AARP Bulletin Today recently covered the story of Rodney Larson, an uninsured Minnesota resident and a Healthbase customer who had his triple bypass surgery at a heart care hospital in Kansas.

According to the bulletin,

As a father to nine daughters, electrician Rodney Larson always looks for ways to cut costs. So in 2008 when he was told he needed triple bypass surgery – totaling $80,000 or more – he shopped around.

Rodney Larson traveled within the United States for heart surgery

Rodney Larson traveled within the United States for heart surgery.

Larson, 56, of Boyd, Minn., searched the Internet and found a hospital that would do the surgery for $13,200. The facility, Galichia Heart Hospital in Wichita, Kan., participates in a domestic medical tourism program run by Healthbase Online.

Located in Boston, Healthbase is one of a handful of companies reaching out to U.S. hospitals to provide specialty surgeries at much lower costs than traditional providers. The company also offers international medical tourism – in which patients travel abroad for procedures – but is finding a market for U.S. specialty hospitals.

Most patients who use medical tourism companies are uninsured and must pay upfront for procedures. Larson liked the one-pay option.

“They saved me a lot of money, but the point is, it was excellent care,” he says.

Source: AARP Bulletin Today

Available procedures
Most major procedures are available at discounted rates within the US through Healthbase. Procedures fall in the categories of cardiac, orthopedic, bariatric, spinal, etc.

Want to know if the procedure you need is available and how much it costs?

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By Victoria Knight, Dow Jones Newswires

A post recently appeared in the Wall Street Journal Blog which talked about Healthbase, Healthbase’s customers and the latest trend in medical tourism or global healthcare – traveling from one state to another within the United States in search for cheaper prices for major surgeries. Healthbase is one company that has been helping American patients connect to affordable hospitals in the US for major surgeries. The author writes,

Uninsured Americans also are shopping around for surgery in the U.S. in record numbers, and using new services such as Healthbase Online Inc. , a Boston-based medical brokerage that arranges treatments for patients at health-care facilities worldwide. Rodney Larson, a self-employed electrician from Minnesota, used Healthbase Online to arrange a triple heart bypass at Galichia Heart Hospital in Wichita, Kansas. He paid $13,000 flat fee for the surgery, about $90,000 dollars less than the rate for uninsured patients in Minnesota.

The current economic conditions…

Worsening economic conditions have made employers and workers more inventive in dealing with ever-rising health-care costs. Some are taking advantage of new health services that offer fixed rates for surgery to patients willing to travel to get care.

The financial benefits of domestic and international medical tourism cannot be overlooked and some insurers have taken active steps to reduce the health care costs for their clients in this slowing economy by offering them medical tourism options. The author mentions about the forward thinking by some health insurers and writes,

It’s a strategy that giving some insurers food for thought. WellPoint Inc., the nation’s largest health insurer, is currently evaluating programs and benefits where customers can “elect to seek certain services at designated facilities for a fixed per-case rate ,” according to a spokeswoman, Jill Becher.

Others insurers aren’t sold on asking customers to travel for health care. Aetna Inc. says it already negotiates significant discounts with medical providers. Typically, it pays physicians within three days of submitting a claim, so up-front cash payments aren’t a strong incentive for achieving additional discounts, according to a company spokesperson.

Request FREE quote for affordable major surgery within US or overseas

More at: Wall Street Journal Blog

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