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States with the Best Healthcare ROI


These 10 states prove it is not necessary to spend a fortune on healthcare to receive quality outcomes.

Given the United States spends $2.9 trillion a year on healthcare, Americans might expect their care outcomes to be better than they really are. A new study from WalletHub found spending more on healthcare does not necessarily translate to the best outcomes.

The study examined the quality of American healthcare relative to its cost using data from 47 states to create a health-related return on investment (ROI) metric. The 3 states not included in the rank were Maine, Rhode Island, and Vermont.

While California’s healthcare costs are slightly higher than the average state, it has the lowest death rate (adjusted by age group). Plus, the state with the best overall health ranking actually has the lowest cost of care in the country.

The results show that expensive health costs are no guarantee of superior care, and that inexpensive care does not equate to poor quality. According to the survey, states in the middle of the country have a better handle on providing the best quality for the money being paid by residents.

These are the states with the best health ROI:

10. Idaho

Healthcare cost rank: 16

Death rate rank: 19

Nation’s health rank: 12


Although Idaho just made the top 10, it might want to look into increasing its provider workforce. The state is expected to have one of the largest projected shortages of primary care physicians, and needs to increase its workforce by 44% by 2030 if it wants to maintain the status quo.

9. Maryland

Healthcare cost rank: 12

Death rate rank: 18

Nation’s health rank: 24


The only East Coast state to make it into the top 10 for best healthcare ROI, Maryland’s residents are less likely to struggle with healthcare costs. Just 14.7% of them do not have enough money for healthcare and/or medicine, according to a Gallup poll.

8. Arizona

Healthcare cost rank: 11

Death rate rank: 21

Nation’s health rank: 28


Arizona may have the best healthcare ROI, but that could change in the future. The state is expected to have the second worst primary care physician shortage with a need to increase the workforce by 50%. The state could run into a terrible accessibility problem with such a large projected shortfall.

7. Nebraska

Healthcare cost rank: 13

Death rate rank: 13

Nation’s health rank: 11


According to the Gallup-Healthways Well-Being Index, Nebraska received the best score on the Life Evaluation index, plus the state had one of the best overall improvements from 2010 to 2013. With a score of 69.7, Nebraska ranked third for well-being in 2013, close behind North and South Dakota.

6. Illinois

Healthcare cost rank: 6

Death rate rank: 22

Nation’s health rank: 30


If it wasn’t for the low cost of care in Illinois, the state would not have made the top 10 considering its death rate and overall health rank are average and worse than average. Residents have the least praise for their state, with just 19% saying Illinois is the best place to live.

4. (tied) Iowa

Healthcare cost rank: 6

Death rate rank: 17

Nation’s health rank: 18

Des Moines

Residents of Iowa struggle the least among Americans to afford healthcare or medicine. According to Gallup, just 12.2% did not have enough money for either one. As a result, Iowa landed just inside the top 10 for best well-being in 2013, according to Gallup.

4. (tied) Hawaii

Healthcare cost rank: 9

Death rate rank: 7

Nation’s health rank: 1


For 4 years in a row, Hawaii had held the top spot for overall well-being. However, in 2013, the state slipped 7 spots. Still, residents have one of the lowest costs of care and the best overall health rank in the nation. The state was also the least stressed out state in 2013 and had one of the highest enjoyment levels.

3. Kansas

Healthcare cost rank: 2

Death rate rank: 29

Nation’s health rank: 27


Although Kansas’ death rate and overall health are just about average, it has one of the least expensive healthcare costs, which landed it at such a high spot on the list. Last year, Gallup reported that Kansas had one of the largest increases in obesity (8.8%) from 2000 to 2011, with nearly a third of adults obese in 2011.

2. Utah

Healthcare cost rank: 3

Death rate rank: 15

Nation’s health rank: 6

Salt Lake City

Utah has the lowest smoking rate in the country, with just 12.2% of residents admitting to smoking, according to a Gallup poll. Healthcare isn’t the only thing the doesn’t cost much—Utah has one of the best tax climates and it has a lower cost of living.

1. Minnesota

Healthcare cost rank: 1

Death rate rank: 2

Nation’s health rank: 3

St. Paul

Proof that care does not have to be expensive in order to provide good, quality outcomes, Minnesota had strong ranks across the board. According to WalletHub, the average individual health insurance premium in Minnesota is $2,292, compared to the nation’s average of $5,884, in 2013. The state also tied with Iowa for the lowest percentage of residents without enough money to pay for healthcare and/medicine.

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