Oklahoma has one of the worst health systems in the nation, a system that overall fails to provide access to care and prevent disease among the state’s adults and children, according to a report released Wednesday.
And if Oklahoma were to improve its health system and implement strategies that brought it among the rankings of the best-performing states, thousands of residents could see better health and potentially longer lives, according to The Commonwealth Fund’s report.
The Commonwealth Fund, a New York-based nonprofit health policy group, released its “Scorecard on State Health System Performance, 2014” on Wednesday.
The report assesses states on 42 indicators of health care access, quality, costs and outcomes over the 2007 to 2012 period, which includes the Great Recession and precedes the major coverage expansions of the Affordable Care Act.
The report details what impact Oklahoma would see if its health system performed more effectively in preventing and treating disease.
For example, if Oklahoma could provide the type of preventive care that Minnesota does for its residents, an estimated 168,951 more adults aged 50 and older would receive preventive care, including colon cancer screenings, mammograms and flu shots.
And if the state were to tackle tooth loss from decay or disease, 206,738 fewer residents, ages 18 to 64, would have lost six or more teeth.
Cathy Schoen, senior vice president of The Commonwealth Fund, said the issues that Oklahoma and other low-performing states face aren’t just problems for state leaders to solve.
“We need to have a broader strategy, and it will need a collaborative approach because we need to enlist our hospital leaders and our doctor leaders,” Schoen, who has worked in public health policy for more than 30 years, said. “It’s not just the state that’s acting. It’s the care system that needs to act in a strategic way.”
The study was broken down into several categories, with states ranked in each category and then also given an overall ranking.
Oklahoma was not ranked among the top five states in any category. The state ranked among the worst states in 25 of the 33 indicators.
For example, Oklahoma ranked poorly because of its high rate of uninsured adults, along with high rates of adults who went without health care because of cost, people who had high out-of-pocket medical expenses and people who were at-risk for disease who went without a doctor visit for two years.
Oklahoma did see improvement in 12 categories, including its rate of children with emotional, behavioral, or developmental problems who received needed mental health care in the past year; its rate of Medicare beneficiaries who received at least one drug that should be avoided in the elderly; and its rate of uninsured children.
The state also performed well in a few categories, including receiving high marks for Oklahoma’s rate of patient-centered hospital care, for home-health patients who got better at walking or moving around and for home-health patients whose wounds healed after an operation. However, in some areas of improvement, the state still ranked poorly when compared to other states.
Schoen said looking forward, states have multiple opportunities to receive federal funding to improve their health systems, including receiving federal money to expand their Medicaid programs.
Oklahoma is among several states that have not expanded their Medicaid programs, a key element under the Affordable Care Act, sometimes referred to as Obamacare.
In total, 16 of the 23 states that performed poorly in the Commonwealth study have not accepted federal money to expand their Medicaid programs, Schoen said.
Many of the worst performing states were in the South, including Oklahoma, Texas, Arkansas, Louisiana, Mississippi, Alabama and Tennessee.
Schoen, who served as staff to President Jimmy Carter’s national health insurance task force, said in her lifetime, she had not seen so much federal funding available to help states improve their health systems and focus on improving health outcomes.
“There’s an opportunity with these new resources and tools on the table — for every state — if all states were to take them up,” she said. “Particularly in the states that are not doing as well as the top 10 states are, I think there's potential to shrink the geographic gap.”
And if states like Oklahoma don’t take proactive stances now, Schoen said it doesn’t necessarily mean they’ll move backward from where they are.
“But the other states will improve — and improve faster,” she said.