In the third National Scorecard on U.S. Health System Performance the U.S. health care system achieved a score of 64 out of 100. Despite pockets of improvement, the United States as a whole failed to improve when compared with the top 10 percent of U.S. states, regions, health plans, or health care providers, or the top-performing countries. The scorecard measures the health system across 42 key indicators of health care quality, access, efficiency, equity, and healthy lives.
The cost and quality of health care, as well as access to care and health outcomes, continue to vary widely among states, according to the Commonwealth Fund Commission on a High Performance Health System's second state scorecard report. The states that led in the first state scorecard, released in 2007, generally continued to lead, often setting new benchmarks and widening the gap between leading and lagging states.