In a study of state-by-state comparison of 50 states and the District of Columbia, in reference to the access, and quality of health care, Tennessee was ranked 39th among the U.S. states.

Leading the league of low-performing states, Tennessee was ranked, 49th position, in healthy living indicator, and slightly better on access to health care, prevention and treatment.

“When it comes to access to care when you need it, the quality of care you receive, and the likelihood of living a healthier life, where you live matters,” the report says.

“Wide variations in care and outcomes persist, with top-performing states continuing to surpass their peers on multiple dimensions.”

The Commonwealth Fund, a private fund carries independent research on health care issues, released its second report on state scorecard on health system performance, 2009, on Wednesday.

The Fund rates states health care system on 37 various indicators classifying into a five broad categories: access to health care, prevention and treatment, avoidable hospital use and costs, healthy lives and equity.

New England and Upper Midwest states scored high rating in multiple indicators, where as southern states scored low.

"Access and quality are tightly related. People who don't have access receive much lower levels of preventive care." The report stated across states, health insurance coverage for adults declined, health care costs rose.

The report pointed the urgent need for comprehensive national health system reform because of continuing and growing disparities in state performance.

Joel Cantor, Director of Rutgers University and co-author of the report said, "If we rely exclusively on the states to cover the people, whole sections in the U.S. may not be covered."

Tennessee was ranked 41st two years ago. In terms of equity, one of the parameters of the study, the report states Hispanic and Black groups as the most vulnerable.

If Tennessee improves to the level of the best-performing state, 491,817 more adults, 116,062 more children would be would be covered by health insurance, and 67.69 million dollars would be saved from reducing Medicare readmissions.

The TennCare program’s aim of ‘managed care model to generate sufficient savings to extend additional coverage, who would not otherwise be Medicaid eligible, without compromising quality of care,’ appears not being attained.

Tennessee Health Commissioner Susan R. Cooper said, "While we are pleased with the improvement in ranking, we are not satisfied, and recognize there is still work to do," she added, "the data was collected before the initiation of Tennessee's Non-Smokers Protection Act, focused efforts aimed at reducing infant mortality and programs like Project Diabetes and Get Fit Tennessee. We have received more recent data reflecting improvements in healthy lifestyle behaviors.

You can see that our state's ranking is significantly influenced by our lifestyle behaviors. Tennesseans of all ages across the state are moving more, making healthier nutritional choices and are continuing their efforts to reduce tobacco use. We hope to see the benefits of this as well as other state initiatives reflected in future rankings."

Tennessee is ranked 49th among the states on healthy lives; 41th and 27th on avoidable hospital use and prevention and treatment respectively.

But the state is ranked 29th on equity and access to the health care, which it slipped from 26th in the year 2007.

Shelley Walker, Communication and Marketing Coordinator of
Tennessee Department of Health said, "It would be premature for us to comment at this time, as we cannot speculate on what impact the report may have on the various health care proposals."

The report finds the health insurance coverage for adults declined in a majority of states since 2007 and the majority of states made gains in health coverage for children due to federal and state support for the Children’s Health Insurance Program (CHIP).

Cathy Schoen, the Commonwealth Fund Senior Vice President and study co-author said, “Where you live in the U.S. matters in terms of your health care, and it shouldn’t. These wide and persistent gaps among states highlight the need for national reforms and federal action to support states.”

Vermont, Hawaii, Iowa, Minnesota, Maine, and New Hampshire lead the nation as top performers on a majority of scorecard indicators. Leading states set new, higher benchmarks on a majority of indicators, while Mississippi, Oklahoma, Louisiana, Arkansas and Nevada were on the bottom of the list.

According to the report, if the low-performing states could improve to the level of their high-achieving counterparts, 78,000 premature deaths could be avoided, 29 million additional people would be insured, 30 million adults and children would have a usual source of primary care, 9 million additional adults aged 50 and above, and nearly 4 million diabetics received recommended care. Nearly 4 million diabetics would receive critical annual preventive care, and states would save $22 billion a year in Medicare costs.

Sumanth Garakarajula can be reached at 347-767-6466 or Sumanth@journalist.com