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Americans receive the best healthcare in Massachusetts and the worst healthcare in Alabama. 

This is according to a report by WalletHub, which compared all 50 states and the District of Colombia on cost, access, outcomes, and other secondary factors. 

The WalletHub report compares the states using 44 measures of health care cost, access, and outcomes. The measures included; average monthly insurance premium, average wait time at the emergency room, and life expectancy. The report used data from different sources such as the U.S. Census Bureau and the Bureau of Labor Statistics, among other sources.

The report found that West Virginia, Wyoming, and Vermont have the highest average monthly insurance premium while Utah has the lowest.

The report further shows that Washington, D.C., has the most hospital beds and physicians per capita. Washington, D.C. tied with Wyoming for the states with the most dentists per capita. Tennessee has the fewest dentists per capita.

The state of Utah has the fewest hospital beds per capita, while Idaho has the fewest physicians per capita.

Source: Yahoo Finance

The 10 best states for healthcare from the report are; 

1. Massachusetts

2. Rhode Island

3. Minnesota 

4. Hawaii

5. Maryland

6. Vermont

7. Colorado 

8. Iowa

9. Connecticut

10. South Dakota

The 10 worst states for healthcare from the report are;

1. Alabama

2. Louisiana

3. Arkansas

4. Mississippi

5. North Carolina

6. Oklahoma

7. Wyoming

8. West Virginia

9. Nevada

10. Missouri

Does Medicaid improve access to care?

The Bay State ranked first overall. It leads in access and outcomes and has the highest number of insured children and adults. Massachusetts also ranks among the top five states in the lowest infant mortality rate and lowest percentage of adults making no dental visits in the past year.

In an interesting twist, though, Massachusetts ranked 24th in cost, meaning that having access to health care is a necessary step but not a sufficient step to achieve good healthcare.

A notable impact on Medicaid expansion can be seen. 9 out of the 12 states that have not adopted the expansion are ranked at the bottom in terms of overall healthcare.

In the states with the highest uninsured rates for children and adults, an overwhelming majority are not Medicaid expansion states.

Medicaid expansion would help to provide patients additional insurance to access healthcare. Be that as it may, several other variables also impact the Medicaid expansion impact, such as; Do new Medicaid patients have access to doctors and hospitals with the new insurance coverage? 

If there is no growth in clinical services accepting Medicaid, the expansion of Medicaid alone may not lead to better overall healthcare systems.

What about the cost of accessing health care?

The WalletHub report factored in the cost of insurance as well. Alabama has the highest average monthly insurance premium, with Louisiana, West Virginia, Wyoming, and Vermont ranking in the top five. Utah, on the other hand, has the lowest average monthly insurance premium, followed by Idaho, Massachusetts, Maryland, and Minnesota, in that order. 

Health care costs and pricing are driven by different market variables. Some areas only have one hospital, while others have only one healthcare system. These two factors have impacts on the overall cost of healthcare and insurance premiums. Also, the disease burden varies in different states, impacting the premiums charged.

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Jennifer Billings is the Medical Editor at Medicwell. She is an Integrated medical doctor who has been published on Medicwell Blog, Medium.com and is a regular contributor at MedCity News, Physician Family, and Psychology Today.