Missouri State Scorecard - The Commonwealth Fund

State Scorecard

Missouri Tables (689k PDF)

Missouri

Rankings

Overall : 36
Access: 30
Prevention & Treatment: 30
Avoidable Hospital Use & Costs: 28
Equity^b: 33
Healthy Lives: 41

Number of indicators for which this state ranked in the:

Top 5: 0
Top Quartile: 3
2nd Quartile: 8
3rd Quartile: 18
Bottom Quartile: 9
Bottom 5: 2

Change in Rates

Total no. of indicators with trends^c: 35
State Rate Improved ≥5%: 15 (43%)
State Rate Worsened ≥5%: 9 (26%)
Little/No change in State Rate: 11 (31%)

Estimated Impact of Improvement*

*if this state improved to the level of the best-performing state
Number of adults who would be insured: 340,666
Children with a medical home: 64,117
Dollars that would be saved from reducing Medicare readmissions: $60,230,053

More Estimates »

Dimension and Indicator	Year	State Rate	All States Median	Top 5 States Average	Best State Rate	Rank	Year	State Rate	All States Median Rate	Rank	Actual Change in State Rate	Percent Change in State Rate
Access	2009 Scorecard					30	Revised 2007 Scorecard^a			21	Change in Rate^d
Percent of Nonelderly Adults (Ages 18–64) Insured	2007/2008	83.4	82.2	89.5	92.8	22	2004/2005	84.2	82.4	19	-0.8	-1.0%
Percent of Children (Ages 0–17) Insured	2007/2008	91.4	91.4	95.3	96.8	26	2004/2005	92.6	91.5	15	-1.2	-1.3%
Percent of At-Risk Adults Who Have Visited a Doctor for a Routine Checkup in the Past Two Years	2006/2007	80.4	84.1	91.5	93.0	40	1999/2000	86.7	87.0	27	-6.4	-7.4%
Percent of Adults Without a Time in the Past Year When They Needed to See a Doctor but Could Not Because of Cost	2006/2007	85.9	87.5	92.5	93.1	34	2003/2004	88.3	87.6	20	-2.4	-2.7%
Prevention & Treatment	2009 Scorecard					30	Revised 2007 Scorecard^a			33	Change in Rate^d
Percent of Adults Age 50 and Older Received Recommended Screening and Preventive Care	2006	42.4	42.4	50.8	52.5	25	2004	38.5	39.7	32	4.0	10.4%
Percent of Adult Diabetics Received Recommended Preventive Care^e	2006/2007	44.2	44.8	57.1	66.9	26	2003/2004	44.5	44.4	23	-0.3	-0.7%
Percent of Children Ages 19–35 Months Received All Recommended Doses of Five Key Vaccines	2007	77.2	80.1	90.0	93.2	42	2005	79.3	81.6	31	-2.1	-2.6%
Percent of Children with Both a Medical and Dental Preventive Care Visit in the Past Year^f	2007	66.7	71.0	82.7	85.3	41	2003	56.1	59.2	33	—	—
Percent of Children Who Received Needed Mental Health Care in the Past Year	2007	73.9	63.0	77.5	81.5	6	2003	60.2	61.9	31	13.7	22.8%
Percent of Hospitalized Patients Who Received Recommended Care for Heart Attack, Heart Failure, and Pneumonia	2007	92.9	91.6	95.2	95.6	17	2004	84.8	84.4	22	8.1	9.6%
Percent of Surgical Patients Who Received Appropriate Care to Prevent Complications	2007	85.1	85.3	91.3	92.7	28	2004	71.1	70.5	24	14.1	19.8%
Percent of Home Health Patients Who Get Better at Walking or Moving Around	2007	42.2	40.5	46.1	48.2	14	2005	37.2	36.2	23	5.0	13.4%
Percent of Adults with a Usual Source of Care	2006/2007	82.1	81.8	88.6	89.0	23	2003/2004	83.3	81.5	15	-1.1	-1.3%
Percent of Children with a Medical Home^f	2007	64.8	60.7	67.5	69.3	8	2003	47.7	47.6	25	—	—
Percent of Heart Failure Patients Given Written Instructions at Discharge	2007	73.3	75.1	86.8	91.4	32	2004	50.0	50.6	28	23.3	46.6%
Percent of Medicare Patients Whose Health Care Provider Always Listens, Explains, Shows Respect, and Spends Enough Time with Them^g	2007	72.0	74.5	77.7	78.0	41	2003	68.4	68.7	34	3.6	5.3%
Percent of Medicare Patients Giving a Best Rating for Health Care Received in the Past Year^g	2007	62.5	61.1	67.6	69.3	17	2003	69.1	70.2	33	-6.6	-9.6%
Percent of High-Risk Nursing Home Residents with Pressure Sores	2007	11.6	11.5	7.7	7.5	27	2004	13.5	13.2	32	1.9	14.0%
Percent of Long-Stay Nursing Home Residents Who Were Physically Restrained	2007	5.9	4.0	1.7	1.5	39	2004	7.1	6.2	33	1.2	17.0%
Percent of Long-Stay Nursing Home Residents Who Have Moderate to Severe Pain	2007	4.8	4.2	2.1	0.9	33	2004	7.0	6.3	32	2.2	31.4%
Avoidable Hospital Use & Costs	2009 Scorecard					28	Revised 2007 Scorecard^a			28	Change in Rate^d
Hospital Admissions for Pediatric Asthma per 100,000 Children^h	2005	167.2	125.5	63.5	48.6	31	2003	174.5	152.6	23	7.3	4.2%
Percent of Adult Asthmatics with an Emergency Room or Urgent Care Visit in the Past Yearⁱ	2001-2004	18.7	16.3	11.8	10.8	25	2001-2004	18.7	16.3	25	—	—
Medicare Hospital Admissions for Ambulatory Care Sensitive Conditions per 100,000 Beneficiaries	2006/2007	7,256	6,291	4,136	3,725	36	2003/2004	7,770	6,845	35	514	6.6%
Medicare 30-Day Hospital Readmissions as a Percent of Admissions	2006/2007	18.3	17.5	13.8	12.9	29	2003/2004	18.3	17.1	32	-0.1	-0.5%
Percent of Long-Stay Nursing Home Residents with a Hospital Admission^j	2006	21.6	18.7	9.0	6.9	36	2000	20.2	16.6	36	-1.4	-6.9%
Percent of Nursing Home Residents with Hospital Readmission Within 30 Days^j	2006	21.7	20.8	14.6	13.2	29	2000	19.8	18.2	32	-1.9	-9.6%
Percent of Home Health Patients with a Hospital Admission	2007	26.9	28.7	22.0	21.2	18	2004	26.6	26.9	24	-0.3	-1.1%
Hospital Care Intensity Index, Based on Inpatient Days and Inpatient Physician Visits Among Chronically Ill Medicare Beneficiaries in the Last Two Years of Life	2005	0.977	0.958	0.556	0.509	30	2003	0.974	0.959	30	-0.003	-0.3%
Total Single Premium per Enrolled Employee at Private Sector Establishments that Offer Health Insurance	2008	4,124	4,360	3,904	3,830	11	2004	3,559	3,706	15	-565	-15.9%
Total Medicare (Part A & Part B) Reimbursements per Enrollee	2006	7,709	7,698	6,027	5,311	28	2003	6,278	6,371	22	-1,431	-22.8%
Healthy Lives	2009 Scorecard					41	Revised 2007 Scorecard^a			43	Change in Rate^d
Mortality Amenable to Health Care, Deaths per 100,000	2004/2005	103.0	89.9	68.2	63.9	36	2001/2002	112.9	95.6	34	9.9	8.8%
Infant Mortality, Deaths per 1,000 Live Births	2005	7.5	6.8	5.0	4.5	35	2002	8.5	7.1	42	1.0	11.8%
Breast Cancer Deaths per 100,000 Female Population	2005	28.0	23.7	19.5	17.7	49	2002	26.1	25.3	33	-1.9	-7.3%
Colorectal Cancer Deaths per 100,000 Population	2005	18.3	17.8	14.3	13.3	30	2002	21.3	20.0	39	3.0	14.1%
Suicide Deaths per 100,000 Population	2005	12.4	11.8	6.2	5.5	30	2003	11.8	11.7	27	-0.6	-5.1%
Percent of Nonelderly Adults (Ages 18–64) Limited in Any Activities Because of Physical, Mental, or Emotional Problems	2006/2007	20.3	17.0	13.5	12.0	44	2003/2004	17.4	15.7	38	-2.9	-16.7%
Percent of Adults Who Smoke	2006/2007	23.8	20.1	15.1	10.7	46	2003/2004	25.6	21.4	47	1.8	7.0%
Percent of Children Ages 10–17 Who are Overweight	2007	30.9	30.6	24.7	23.1	27	2003	31.0	29.9	34	0.1	0.3%

^a Some state rates from the 2007 edition have been revised to match methodology used in the 2009 edition.
^b The equity dimension was ranked based on gaps between the most vulnerable group and the U.S. national average for selected indicators. Refer to state equity profiles for information on changes in the gaps.
^c Count does not include indicators for which data could not be updated or do not allow assessment of trends.
^d Change in rate is expressed such that a positive value indicates performance has improved and a negative value indicates performance has worsened.
^e Data available for 45 states in 2006-07; 47 states in 2003-04.
^f Data for 2003 and 2007 are not comparable because of changes in survey design.
^g Data available for 50 states in 2007.
^h Data available for 35 states in 2005; 33 states in 2003.
ⁱ Data available for 36 states in 2001-04. Data presented here are used for both past and current ranking.
^j Data available for 48 states.
^* Data could not be updated for this state.
Note: Refer to Appendix B in the State Scorecard for indicator descriptions, data sources, and other notes about methodology.

The equity profile displays gaps in performance for vulnerable populations for selected indicators. An equity gap is defined as the difference between the U.S. national average for a particular indicator and the rate for the state's most vulnerable group by income, insurance coverage, and race/ethnicity. For all equity indicators, lower rates are better; therefore, a positive or negative gap value indicates that the state's most vulnerable group is better or worse than the U.S. average for a particular indicator.

Dimension and Indicator	Year	U.S. Average	Vulnerable Group Rate	Gap	Rank	Year	U.S. Average	Vulnerable Group Rate Rate	Gap	Rank	Change in Gap	Change in Vulnerable Group Rate
Equity	2009 Scorecard				33	Revised 2007 Scorecard^b				24	Change in Gap and Vulnerable Group Rate^c
Income
Percent Uninsured, Ages 0–64 by Federal Poverty Level^d	2006/2007	17.5	30.7	-13.2	25	2004/2005	17.1	26.4	-9.3	17	-3.9	-4.3
Percent of At-Risk Adults Who Have Not Visited a Doctor for a Routine Checkup in the Past Two Years by Federal Poverty Level	2006/2007	15.4	24.7	-9.3	39	1999/2000	13.1	15.8	-2.7	24	-6.6	-8.9
Percent of Adults with a Time in the Past Year When They Needed to See a Doctor but Could Not Because of Cost by Federal Poverty Level	2006/2007	13.4	28.5	-15.1	38	2003/2004	13.1	22.9	-9.8	20	-5.3	-5.6
Percent of Adults Age 50 and Older Did Not Receive Recommended Screening and Preventive Care by Federal Poverty Level	2006	57.7	68.5	-10.8	23	2004	60.3	68.8	-8.5	23	-2.3	0.3
Percent of Adult Diabetics Did Not Receive Recommended Preventive Care by Federal Poverty Level^e	2006/2007	55.7	64.2	-8.6	32	2003/2004	59.0	63.0	-4.0	27	-4.6	-1.2
Percent of Children Without Both a Medical and Dental Preventive Care Visit in the Past Year by Federal Poverty Level^f	2007	28.4	46.2	-17.8	46	2003	41.2	59.9	-18.7	47	—	—
Percent of Adults Without a Usual Source of Care by Federal Poverty Level	2006/2007	20.3	25.8	-5.6	23	2003/2004	20.7	22.4	-1.6	11	-3.9	-3.5
Percent of Children Without a Medical Home by Federal Poverty Level^f	2007	42.5	50.7	-8.2	9	2003	53.9	66.4	-12.5	31	—	—
Percent of Adult Asthmatics with an Emergency Room or Urgent Care Visit in the Past Year by Federal Poverty Level^g	2001-2004	17.6	27.2	-9.6	26	2001-2004	17.6	27.2	-9.6	26	—	—
Insurance Coverage
Percent of At-Risk Adults Who Have Not Visited a Doctor for a Routine Checkup in the Past Two Years by Whether Insured	2006/2007	15.4	50.0	-34.6	48	1999/2000	13.1	31.2	-18.1	23	-16.5	-18.8
Percent of Adults with a Time in the Past Year When They Needed to See a Doctor but Could Not Because of Cost by Whether Insured	2006/2007	13.4	49.8	-36.4	48	2003/2004	13.1	40.5	-27.3	28	-9.0	-9.3
Percent of Adults Age 50 and Older Did Not Receive Recommended Screening and Preventive Care by Whether Insured	2006	57.7	75.5	-17.8	27	2004	60.3	77.9	-17.6	38	-0.3	2.3
Percent of Children Ages Without Both a Medical and Dental Preventive Care Visit in the Past Year by Health Insurance Type^f	2007	28.4	53.7	-25.3	35	2003	41.2	58.7	-17.5	21	—	—
Percent of Adults without a Usual Source of Care by Whether Insured	2006/2007	20.3	52.8	-32.6	30	2003/2004	20.7	50.5	-29.8	25	-2.7	-2.3
Percent of Children Without a Medical Home by Health Insurance Type^f	2007	42.5	51.3	-8.8	10	2003	53.9	67.1	-13.2	14	—	—
Race/Ethnicity
Percent Uninsured, Ages 0-64 by Race/Ethnicity^d	2006/2007	17.5	25.8	-8.3	11	2004/2005	17.1	26.9	-9.8	14	1.5	1.1
Percent of At-Risk Adults Who Have Not Visited a Doctor for a Routine Checkup in the Past Two Years by Race/Ethnicity	2006/2007	15.4	36.2	-20.8	50	1999/2000	13.1	21.3	-8.2	38	-12.5	-14.8
Percent of Adults with a Time in the Past Year When They Needed to See a Doctor but Could Not Because of Cost by Race/Ethnicity	2006/2007	13.4	21.3	-7.9	20	2003/2004	13.1	20.3	-7.2	23	-0.7	-1.0
Percent of Adults Age 50 and Older Did Not Receive Recommended Screening and Preventive Care by Race/Ethnicity^h	2006	57.7	76.4	-18.7	43	2004	60.3	75.8	-15.5	40	-3.1	-0.5
Percent of Children Without Both a Medical and Dental Preventive Care Visit in the Past Year by Race/Ethnicity^f	2007	28.4	32.0	-3.6	14	2003	41.2	58.2	-17.0	36	—	—
Percent of Adults Without a Usual Source of Care by Race/Ethnicity	2006/2007	20.3	35.0	-14.8	19	2003/2004	20.7	21.9	-1.1	5	-13.6	-13.2
Percent of Children Without a Medical Home by Race/Ethnicity^f	2007	42.5	53.9	-11.4	8	2003	53.9	62.2	-8.3	12	—	—
Mortality Amenable to Health Care, Deaths per 100,000 Population by Raceⁱ	2004/2005	95.6	196.0	-100.4	36	2001/2002	105.2	212.6	-107.4	36	7.0	16.6
Infant Mortality, Deaths per 1,000 Live Births by Race/Ethnicity	2002-2004	6.9	14.8	-7.9	35	2000-2002	6.9	15.6	-8.7	41	0.8	0.8

^a Count does not include indicators for which data could not be updated or do not allow assessment of trends.
^b Some state rates from the 2007 edition have been revised to match methodology used in the 2009 edition.
^c Change in the gap or vulnerable group is expressed such that a positive sign indicates performance has improved and a negative sign indicates performance has worsened.
^d Data by income available for 50 states. Data by race/ethnicity available for 43 states.
^e Data by income available for 45 states in 2006–07; 47 states in 2003–04.
^f Data for 2003 and 2007 are not comparable because of changes in survey design.
^g Data by income available for 36 states in 2001–04. Data presented here are used for both past and current ranking.
^h Data by race/ethnicity available for 48 states in 2006; 47 states in 2004.
ⁱ Data by race/ethnicity available for 44 states in 2004–05; 43 states for 2001–02.
^j Vulnerable group by insurance is always the uninsured group for all indicators.
^* Data could not be updated for this state.
Note: An equity gap is defined as the difference between the U.S. national average for a particular indicator and the rate for the state's most vulnerable group by income, insurance coverage, and race/ethnicity. For all equity indicators, lower rates are better; therefore, a positive or negative gap value indicates that the state's most vulnerable group is better or worse than the U.S. average for a particular indicator. State Scorecard Data Tables display current data by all subgroups. Refer to Appendix B in the State Scorecard for indicator descriptions, data sources, and other notes about methodology.