Altarum Releases Policy Scorecard Report to Help States Strengthen Efforts to Address Affordability of Health Care

January 07, 2020

Washington, DC, — Altarum’s Healthcare Value Hub today released a scorecard rating 42 states and the District of Columbia on their adoption of evidence-based policy actions to improve affordability of health care for residents.

The Healthcare Affordability State Policy Scorecard shows that many states are taking steps to increase access to coverage, but far fewer are taking other actions to address the affordability of health care for residents, even as polling data repeatedly shows affordability is an issue residents on both sides of the political aisle want their legislators and regulators to act on.

States have the power to make health care more affordable by implementing policies to produce better value for consumers, an increasingly important approach in the absence of federal legislation.

The scorecard shows that state residents struggle to afford healthcare, with 24 percent of adults facing affordability burdens in Maryland, the best performing state, and 57 percent in Mississippi, the worst performing state. This variation in burden appears to be tied to policies enacted at the state level, particularly those that extend coverage or reduce out-of-pocket costs. Approaches that address underlying cost drivers —such as reducing low-value care and curbing excess prices—are still in their infancy and may not be fully reflected in state outcomes at this early stage.

The four policy areas in which Altarum’s Healthcare Value Hub rated states include:

  • extending coverage,
  • lowering out-of-pocket costs,
  • reducing low-value care, and
  • curbing excess prices.

States were also rated on their outcomes in four areas:

  • percent of population that is uninsured,
  • percent of population that is forgoing needed care, delaying care or struggling with medical bills,
  • rates of known low-value care services delivered by providers, and
  • private payer prices relative to the national median.

Lawmakers, policymakers, government officials, consumer advocates, and the public can use this scorecard to understand how their state performs on addressing healthcare affordability relative to other states, and to craft a road map for specific evidence-based policy actions. Additionally, a few exemplar states in this scorecard provide proof-of-concept that other states can emulate.

The Healthcare Affordability State Policy Scorecard provides a call-to-action and road map for people and policymakers to strengthen efforts to address health care affordability,” says Altarum Healthcare Value Hub Director Lynn Quincy. “The scorecard provides a clear guide on where to focus regulatory and reform efforts in 2020 and beyond.”

Even states that ranked at the top of the list, such as Massachusetts, can do more to improve affordability for the 26 percent of its residents who find health care costs burdensome, such as enacting stronger surprise medical billing protections and waging a multi-stakeholder campaign to reduce the use of low-value care services. Oregon also ranked high on many metrics but could do more toward measuring and reducing the provision of low-value care. Read the summary report, state scorecards, and methodology at

About Altarum’s Healthcare Value Hub

The Healthcare Value Hub monitors, translates, and disseminates evidence-based policies and practices that improve value to health care consumers, particularly in the areas of cost and quality. The Hub also connects advocates, researchers, and policymakers to enhance understanding of issues and to spark action on the most promising policies and initiatives. The impact of the Hub is felt nationwide, from Connecticut where its survey of consumers helped pass a drug price transparency bill to a health care reform “bootcamp” for advocates, insurers, providers and other stakeholders in Utah. Learn more at

Altarum is a nonprofit organization that works with federal and state agencies and foundations to design and implement solutions to improve the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We achieve measurable results by combining our expertise in public health and health care delivery with technology, workforce training and continuing education, applied research, and technical assistance. Our innovative solutions lead to better health for beneficiaries and better value for payers.