These are the best & worst states for access to cancer care

Health & Fitness

Written by:

ValuePenguin created a Care Score to analyze the top states for cancer care, considering the potential cost of treatment, access to care and death rates. Minnesota scored the highest, while three states — Wisconsin, Georgia and Oklahoma — tied at the bottom, according to our Care Score metric.

No matter a patient’s location, there are strong and weak attributes of local cancer care. However, ValuePenguin found some similar traits among the lowest-scoring states: high out-of-pocket maximums and the inability to qualify for cost savings on marketplace health care insurance.

Key findings

States with low health insurance costs were our most consistent high performers

To measure affordability, ValuePenguin found the cheapest premiums for a Silver health insurance plan in each state and sorted those according to an even distribution across all 50 states.

The maximum number of points a state could earn was 20. Although no state earned a perfect Care Score, Minnesota’s score of 19 was the highest. Five states — New Mexico, Rhode Island, Arizona, Maryland and Pennsylvania — placed just below Minnesota at 18, and California earned a 17.

These states — along with Michigan, which earned a 16 — all have among the cheapest monthly health insurance premiums compared to the rest of the U.S. In fact, of the top 10 high scorers, just two — Montana and Alaska — fall outside of the range of the cheapest health insurance premiums.

Moreover, the highest-scoring states — except for Montana, New Mexico and California — combine cheap health insurance with low out-of-pocket maximums. This refers to the highest amount policyholders would have to pay for covered services — including payments toward deductibles, coinsurance and copays — before all costs are covered by the insurer. Since insurers can’t set a lifetime or yearly spending limit on the coverage they provide, the out-of-pocket maximum tells the policyholder the maximum amount they could pay in cost sharing.

Finally, the best-scoring states for cancer care all have expanded Medicaid eligibility. In these states, some people with low incomes who wouldn’t normally qualify for Medicaid or marketplace tax credits can receive cheap health coverage and, ultimately, treatment if they develop cancer. Under expanded Medicaid laws, more patients would have access to cancer treatments.

Care Score

State

Cheapest monthly premium

Out-of-pocket maximum

19 Minnesota $265 $6,800
18 New Mexico $313 $8,500
Maryland $339 $6,650
Arizona $330 $7,750
Pennsylvania $343 $6,900
Rhode Island $328 $6,750
17 California $325 $8,200
16 Montana $356 $8,550
Michigan $292 $6,500
Alaska $658 $6,000

Health insurance costs and out-of-pocket maximums in the lowest-scoring states

On the other end, no state earned a Care Score lower than nine. Wisconsin, Georgia and Oklahoma were the lowest-scoring states for cancer care. Unlike in the best-scoring states, affordability is an issue in these states. The cheapest health insurance providers in Georgia and Oklahoma had some of the more expensive premiums in the U.S. These two, along with Wisconsin, haven’t implemented expanded Medicaid — though Oklahoma is set to expand later in 2021. Finally, in each of these three states, the out-of-pocket maximum sits at $8,550, the maximum amount allowed by law.

Care Score

State

Cheapest monthly premium

Out-of-pocket maximum

9 Oklahoma $476 $8,550
Georgia $416 $8,550
Wisconsin $343 $8,550
10 Missouri $413 $8,550
Wyoming $647 $8,550
West Virginia $508 $8,550
Mississippi $419 $8,400
North Carolina $373 $8,550
Texas $381 $8,550
Tennessee $428 $7,300

Utah has the lowest cancer death rate and Idaho has the highest number of hospitals per population, but neither is in our top 10

In addition to affordability, ValuePenguin’s Care Score takes into account cancer death rates and hospitals per 100,000 people. According to the most recent data from the Centers for Disease Control and Prevention (CDC), the average death rate from cancer across the 50 states is 152 per 100,000 people. The average rate among the 10 top-scoring states is 145 per 100,000, but the best states don’t score uniformly well by this metric.

Three of the 10 states with the highest Care Scores — Michigan, Pennsylvania and Rhode Island — fall in the lowest or second-lowest tier (highest death rates), according to our analysis. Michigan, in fact, ranks in the lowest tier for cancer deaths per 100,000 people, but its low health insurance premiums and out-of-pocket maximums help it overcome this deficit.

Similarly, just three states among the top 10 for cancer care ranked well for hospital access. Minnesota, New Mexico and Montana placed in the highest tier for hospital access. In these states, there are an average of 6.6 hospitals per 100,000 residents. Comparatively, in Rhode Island and Pennsylvania, this number slips beneath three, and in California and Arizona, this number is below four.

Care Score

State

Cheapest monthly premium

Out-of-pocket maximum

Medicaid expansion

Death rate

Hospitals per 100,000 people

19 Minnesota $265 $6,800 Yes 143.1 5.8
18 New Mexico $313 $8,500 Yes 136.4 6.2
18 Maryland $339 $6,650 Yes 149.9 4.8
18 Arizona $330 $7,750 Yes 131.9 3.5
18 Pennsylvania $343 $6,900 Yes 156.6 2.9
18 Rhode Island $328 $6,750 Yes 151.6 2.5
17 California $325 $8,200 Yes 135 3.9
16 Montana $356 $8,550 Yes 140.7 8.0
16 Michigan $292 $6,500 Yes 161.1 5.4
16 Alaska $658 $6,000 Yes 141.5 4.6
15 Idaho $467 $8,150 Yes 149.5 10.7
15 Nebraska $527 $8,150 Yes 150.5 8.1
15 Washington $344 $7,350 Yes 145.3 2.7
14 North Dakota $400 $8,550 Yes 145.2 9.6
14 Hawaii $467 $8,500 Yes 123.5 5.1
14 Kentucky $406 $6,850 Yes 181.6 4.6
14 Arkansas $387 $8,400 Yes 168.8 4.6
14 Indiana $329 $8,400 Yes 165.7 4.5
14 Ohio $311 $8,400 Yes 165.2 3.8
14 Maine $392 $7,800 Yes 162.1 3.6
14 New Hampshire $325 $8,500 Yes 143.7 3.5
14 Colorado $278 $8,550 Yes 127.6 2.7
13 Iowa $457 $8,550 Yes 155.3 7.9
13 South Carolina $391 $8,400 No 157.3 6.3
13 Massachusetts $344 $8,550 Yes 142.8 4.3
13 Vermont $574 $6,700 Yes 156 3.8
13 Utah $443 $8,550 Yes 120 3.8
13 Virginia $392 $8,550 Yes 149.3 3.6
13 Connecticut $479 $8,150 Yes 134.1 3.2
13 New York $473 $8,500 Yes 138.2 2.1
13 New Jersey $388 $8,550 Yes 141.3 2.0
12 Louisiana $407 $8,550 Yes 169 9.4
12 South Dakota $473 $8,150 No 145.2 8.6
12 Kansas $441 $8,400 No 156.4 7.4
12 Alabama $509 $8,150 Yes 170.4 4.8
12 Illinois $337 $8,550 Yes 153.5 3.3
12 Delaware $522 $6,900 Yes 159.4 3.2
12 Nevada $352 $8,550 Yes 146.5 2.7
11 Florida $408 $8,550 No 141.7 4.6
11 Oregon $402 $8,550 Yes 150.6 2.3
10 Missouri $413 $8,550 Not implemented 165.3 6.0
10 Wyoming $647 $8,550 No 140.6 5.5
10 West Virginia $508 $8,550 Yes 179.5 5.4
10 Mississippi $419 $8,400 No 179.7 5.0
10 North Carolina $373 $8,550 No 154.2 4.9
10 Texas $381 $8,550 No 142.9 4.0
10 Tennessee $428 $7,300 No 168 4.0
9 Oklahoma $476 $8,550 Not implemented 178.1 6.0
9 Georgia $416 $8,550 No 152.4 4.6
9 Wisconsin $343 $8,550 No 151.5 3.3

Among the lowest-scoring states, the death rate from cancer is comparatively high. Of the 10 lowest-scoring states, half have death rates from cancer that fall into the lowest tier (highest death rates). Another three states in the bottom 10 fall in the second-lowest tier, according to our metric. Only Wyoming is among the states with the lowest death rates, though the state’s high cost of insurance, out-of-pocket maximums and narrow Medicaid eligibility access prevent it from performing better.

By comparison, the average number of hospitals per 100,000 people in the lowest-scoring states improves. In only one of these states, Wisconsin, the number of hospitals falls under four per 100,000 people. The states with the lowest Care Scores are more likely to have enough hospitals relative to their populations to qualify for the second-highest tier. However, despite the high scores, they’re unable to overcome their high out-of-pocket maximums and poor access to Medicaid.

States without expanded Medicaid see higher rates of uninsured people, and less access to health care

According to data from the Office of Disease Prevention and Health Promotion, 88% of people in the U.S. claim to have access to an ongoing source of health care. This number drops to 79% for 25- to 44-year-olds and 52% for those without any form of health insurance coverage.

Although ValuePenguin didn’t factor in the number of uninsured residents when calculating Care Scores, it’s important to note that a widespread lack of insurance would lower the number of people who could get treatment for any disease, including cancer, especially in states without expanded Medicaid.

Indeed, there are 17 states that have a higher-than-average percentage of uninsured residents. Of these states, 10 don’t have expanded Medicaid. Of the states without expanded Medicaid, only Tennessee, Wisconsin and Missouri, which hasn’t yet implemented its expansion, have an average or below-average percentage of uninsured residents.

State

Percentage of population uninsured

Expanded Medicaid?

Texas 11% No
Oklahoma 9% Not implemented
Alabama 8% Yes
Nevada 8% Yes
North Carolina 8% No
Wyoming 8% No
Alaska 7% Yes
Georgia 7% No
Idaho 7% Yes
Mississippi 7% No
South Carolina 7% No
Florida 6% No

Methodology

ValuePenguin developed a Care Score to evaluate the affordability and performance of states when it comes to cancer care. This score combines a state’s position relative to other states in five areas.

  • Cheapest health insurance premium
  • Out-of-pocket maximum
  • Status of Medicaid expansion
  • Cancer death rate per 100,000 people
  • Number of hospitals per 100,000 people

To determine scores, we sorted each state’s value in a category into quartiles — positions in a distribution such that data is distributed across four sectors. We assigned points based on quartiles for each metric: one point for placement in the first quartile, two points for second and so on. The sum of these five areas is our Care Score.

This article originally appeared on ValuePenguin.com and was syndicated by MediaFeed.org.

Image Credit: Deposit Photos.

Leave a Reply

Your email address will not be published.