New national scorecard shows U.S. health system lagging

July 25, 2008

The overall performance of the U.S. health system continues to lose ground, despite investing more resources than any other industrialized nation, according to a new 2008 National Scorecard on U.S. Health System Performance issued by the Commonwealth Fund this week.

This material originally appeared in the July 18, 2008, issue of Health Lawyers Weekly, a publication of the American Health Lawyers Association (www.healthlawyers.org).

The overall performance of the U.S. health system continues to lose ground, despite investing more resources than any other industrialized nation, according to a new 2008 National Scorecard on U.S. Health System Performance issued by the Commonwealth Fund this week.

The 2008 Scorecard found little overall improvement since the Commonwealth Fund Commission on a High Performance Health System issued the first National Scorecard in 2006.

Most notably, said the report Why Not the Best? Results from the National Scorecard on U.S. Health System Performance 2008, is a marked decline in U.S. scores on access, as well lackluster performance on key indicators of health outcomes, quality, and efficiency.

According to the report, the U.S. had an overall score of 65 out of a possible 100 across 37 core indicators of healthy lives, quality, access, efficiency, and equity when compared to national and international top performing benchmarks.

“Despite some encouraging pockets of improvement, the country as a whole has failed to keep pace with levels of performance attained by leading nations, delivery systems, states, and regions,” the report said.

The report highlighted several areas of particular concern-including low scores on efficiency measures (53 out of 100). Lowering insurance administrative costs alone could save up to $100 billion annually at the lowest country rates, the report said.

Other average scores were 72 for healthy lives; 71 for quality; 58 for access, and 71 for equity.

The U.S. also fell to last place among 19 industrialized nations on preventable mortality (i.e. deaths that might have been prevented with timely and effective care). Although U.S. rates improved somewhat from earlier measurements, the nation lagged behind big gains in other countries, the report said.

The report did note some exceptions to the overall trend for “quality measures that have been the focus of national campaigns or public reporting.”

For example, rates of controlling two common chronic conditions, diabetes and high blood pressure, have improved significantly with public reporting and pay for performance initiatives.

Closing the performance gap could help prevent 101,000 premature deaths, improve access to preventative care for 70 million more adults, and save Medicare at least $12 billion per year, the report noted.

Read the report