Six of the 30 best performing local health systems are in the ERC region, according to the Commonwealth Fund’s 2016 Local Health System Scorecard – York PA, Providence RI, Lebanon NH, Boston MA, Worcester MA, and Rochester NY. Six ERC states — NH, CT, VT, MA, RI, and ME — were among the best nine in avoiding premature deaths preventable with better health care. None of the 30 lowest performing localities are in the ERC region. However health care costs more in ERC states than the rest of the nation, but there are important differences between Medicare and employer-sponsored coverage costs. There is wide variation between localities across the report’s 36 health care indicators of quality, access, avoidable hospital use, costs and outcomes. Generally low-income areas perform more poorly but the report includes important lessons that overcome that link. Investments in public health are making a difference including school-based care, social service collaborations, workforce training, data, and connecting people to coverage and medical homes. Overall the report found almost all localities in the US are making progress improving health but very slowly. New policies are making a difference including Affordable Care Act coverage expansions, Medicare’s hospital readmission and quality reporting initiatives, and FDA regulations and protections.
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