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North Carolina

A collection of resources on health system performance in North Carolina.

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View of the Great Smoky Montains, North Carolina

#29 in our 2025 State Rankings

The 2025 Scorecard on State Health System Performance uses the most recent available data to assess how well the health care system is working for people in every state. See why North Carolina ranked #29 this year.

Read the Scorecard →

Featured Performance Indicators

12 %

Uninsured adults
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308

Premature avoidable deaths per 100,000 population
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149

Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
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North Carolina Performance Data

Show All Performance Areas
Access to Health Care
Children
Consumer Insurance and Medical Costs
Health Care System Spending
Health Insurance Coverage
Health Status and Outcomes
Health and Reproductive Care for Women
Hospital Safety and Quality
Mental Health
Older Adults
Outpatient Safety and Quality
Post-Acute Care and Long Term Care
Potentially Avoidable Care
Preventive and Well Care
Primary Health Care
Working Age Adults
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Access to Health Care

Access to Health Care
Indicator
Latest
U.S. Avg.
Adults who went without care because of cost
11.3%
2024
12.4%
Adults with a usual source of care
82.3%
2024
83.1%
Adults with any mental illness reporting unmet need
24.6%
2022-23
25.2%
Adults with any mental illness who did not receive treatment
51.1%
2019-20
54.7%
Adults with substance use disorder who did not receive treatment
78.5
2022-23
77.1
Adults without a dental visit
34.2%
2024
33.9%
Children who received needed mental health care
82.6%
2022-23
80.1%
Children with a medical and dental preventive care visit in the past year
72.4%
2022-23
67.6%
Children with a medical home
52.2%
2022-23
43.8%
Youth with depression who did not receive mental health services
50.1%
2022-23
50.8%

Children

Children
Indicator
Latest
U.S. Avg.
Children who are overweight or obese
30.9%
2022-23
31.1%
Children who received needed mental health care
82.6%
2022-23
80.1%
Children with a medical and dental preventive care visit in the past year
72.4%
2022-23
67.6%
Children with a medical home
52.2%
2022-23
43.8%
Children with all recommended vaccines
76.8%
2023
69.5%
Infant mortality per 1,000 live births
6.8
2022
5.6
Uninsured children
5.4%
2024
6%
Youth with depression who did not receive mental health services
50.1%
2022-23
50.8%
Consumer Insurance and Medical Costs
Consumer Insurance and Medical Costs
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who went without care because of cost
11.3%
2024
12.4%
Employee contribution to total premium cost for employer-sponsored health insurance plans
$5,731
2023
$5,510
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
7.9%
2023
6.8%
Employee deductible for employer-sponsored health insurance plans
$3,651
2023
$3,259
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
5%
2023
4%
Employee total potential out-of-pocket medical costs
$9,382
2023
$8,769
Employee total potential out-of-pocket medical costs, as a share of state median income
13%
2023
10.8%
Individuals with high out-of-pocket medical spending
10.9%
2023-24
9.5%
People with medical debt in collections
8.46%
2023
5.04%
Total premium cost for employer-sponsored health insurance plans
$18,765
2023
$19,799
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
25.9%
2023
24.4%
Health Care System Spending
Health Care System Spending
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Doctors' office visit employer-sponsored insurance spending per enrollee
$674
2023
$608
Doctors' office visit spending per Medicare beneficiary
$1,092
2023
$1,155
Home health spending per Medicare beneficiary
$442
2023
$527
Inpatient employer-sponsored insurance spending per enrollee
$1,223
2023
$1,470
Inpatient spending per Medicare beneficiary
$2,444
2023
$2,695
Primary care spending as share of total, age 65 and older
6.8%
2023
5.7%
Primary care spending as share of total, ages 18–64
8.7%
2023
6.8%
Primary care spending per beneficiary, age 65 and older
$765
2023
$740
Primary care spending per enrollee, ages 18–64
-
2023
-
Public health funding
$15
2019
$40
Skilled nursing facility spending per Medicare beneficiary
$717
2023
$875
Total employer-sponsored insurance spending per enrollee
$6,252
2023
$6,437
Total spending per Medicare beneficiary
$10,869
2023
$11,792
Health Insurance Coverage
Health Insurance Coverage
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Uninsured adults
12.1%
2024
11.3%
Uninsured children
5.4%
2024
6%
Uninsured women, during pregnancy
-
2021
2.6%
Uninsured women, pre-conception
-
2021
11.6%
Health Status and Outcomes
Health Status and Outcomes
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
36.2%
2024
34.3%
Adults who have lost six or more teeth
8.9%
2024
8.1%
Adults who report fair or poor health
16.4%
2024
17.8%
Adults who smoke
11.6%
2024
10.9%
Alcohol deaths per 100,000 population
11.1
2023
12.6
All-cause mortality rate per 100,000 women ages 15–44
133.7
2022
110.3
Breast cancer deaths per 100,000 female population
19.6
2023
18.7
Children who are overweight or obese
30.9%
2022-23
31.1%
Colorectal cancer deaths per 100,000 population
13.1
2023
13
Drug overdose deaths per 100,000 population
33.7
2023
31.3
Firearm deaths per 100,000 population
16.4
2023
13.7
Hospital 30-day mortality
14.6%
07/2020 - 06/2023
14.4%
Infant mortality per 1,000 live births
6.8
2022
5.6
Maternal mortality per 100,000 live births
33.4
2020-2022
26.3
Mortality amenable to health care, deaths per 100,000 population
90.6
2019-20
86.8
Premature avoidable deaths per 100,000 population
307.8
2022-23
277.5
Premature deaths from preventable causes per 100,000 population
213.4
2022-23
191.8
Premature deaths from treatable causes per 100,000 population
94.4
2022-23
85.7
Public health funding
$15
2019
$40
Suicide deaths per 100,000 population
14.3
2023
14.1
Health and Reproductive Care for Women
Health and Reproductive Care for Women
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
78.2%
2020
75.8%
Adult women who received a mammogram
82.2%
2024
79.5%
Adult women who received a recommended cervical cancer screening test
88%
2024
83.1%
All-cause mortality rate per 100,000 women ages 15–44
133.7
2022
110.3
Breast cancer deaths per 100,000 female population
19.6
2023
18.7
Infant mortality per 1,000 live births
6.8
2022
5.6
Maternal mortality per 100,000 live births
33.4
2020-2022
26.3
No early prenatal care
27.6%
2022
23%
Preterm birth rate
10.7%
2022
10.4%
Recently pregnant women with a dental cleaning during pregnancy
-
2021
45%
Self-pay in-hospital births
7.8%
2022
2.9%
Uninsured women, during pregnancy
-
2021
2.6%
Uninsured women, pre-conception
-
2021
11.6%
Women experiencing intimate partner violence
-
2021
3.1%
Women who received a flu shot before or during pregnancy
-
2021
56.7%
Women who received a postpartum depression screening
-
2021
89.2%
Women with depression before or during pregnancy
-
2021
21.8%
Women with postpartum depression
-
2021
12.6%
Women without a postpartum checkup after birth
-
2021
9.1%
Hospital Safety and Quality
Hospital Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Care Transition Preparedness (out of 100 points)
49
2023
48
Central line-associated bloodstream infection (CLABSI), Standardized Infection Ratio
0.872
2023
0.724
Communication about medicines (out of 100 points)
59
2023
58
Communication with doctors (out of 100 points)
79
2023
76
Communication with nurses (out of 100 points)
77
2023
76
Hospital 30-day mortality
14.6%
07/2020 - 06/2023
14.4%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
30.6
2023
35
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
2.8
2023
2.9
Hospital discharge instructions for home recovery
87%
2023
86%
Hospital discharge planning and instructions for home recovery (out of 100 points)
86
2023
85
Hospitals with better-than-average patient experience ratings
32%
2023
27%
Patients' overall hospital experience (out of 100 points)
67
2023
67
Responsiveness of hospital staff (out of 100 points)
60
2023
59
Mental Health
Mental Health
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with any mental illness reporting unmet need
24.6%
2022-23
25.2%
Adults with any mental illness who did not receive treatment
51.1%
2019-20
54.7%
Adults with substance use disorder who did not receive treatment
78.5
2022-23
77.1
Alcohol deaths per 100,000 population
11.1
2023
12.6
Antidepressant use and adherence for depression
27%
2023
29.6%
Children who received needed mental health care
82.6%
2022-23
80.1%
Drug overdose deaths per 100,000 population
33.7
2023
31.3
Firearm deaths per 100,000 population
16.4
2023
13.7
Suicide deaths per 100,000 population
14.3
2023
14.1
Women who received a postpartum depression screening
-
2021
89.2%
Women with depression before or during pregnancy
-
2021
21.8%
Women with postpartum depression
-
2021
12.6%
Youth with depression who did not receive mental health services
50.1%
2022-23
50.8%
Older Adults
Older Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
At risk adults with a recent check-up
92.3%
2024
91.9%
Doctors' office visit spending per Medicare beneficiary
$1,092
2023
$1,155
Home health patients with a hospital admission
16%
2019
15%
Home health spending per Medicare beneficiary
$442
2023
$527
Hospital 30-day mortality
14.6%
07/2020 - 06/2023
14.4%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
30.6
2023
35
Inpatient spending per Medicare beneficiary
$2,444
2023
$2,695
Long-stay nursing home residents with a hospital admission
18%
2020
17%
Older adults who received the pneumonia vaccine
72%
2024
70.3%
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
149.4
2023
155.2
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
29.6
2023
30.6
Primary care spending as share of total, age 65 and older
6.8%
2023
5.7%
Primary care spending per beneficiary, age 65 and older
$765
2023
$740
Short-stay nursing home residents with a 30-day readmission to the hospital
20%
2020
18%
Skilled nursing facility patients with a hospital readmission
21.7598%
2023
23.1493%
Skilled nursing facility spending per Medicare beneficiary
$717
2023
$875
Skilled nursing patients with a successful discharge
59%
2020
57%
Total spending per Medicare beneficiary
$10,869
2023
$11,792
Outpatient Safety and Quality
Outpatient Safety and Quality
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
58.7%
2023
63.2%
Appropriate antibiotic among adults with bacterial pneumonia
48%
2023
41.3%
Home health patients who got better at taking their drugs correctly by mouth
86%
2023
86%
Post-Acute Care and Long Term Care
Post-Acute Care and Long Term Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Home health patients who got better at taking their drugs correctly by mouth
86%
2023
86%
Home health patients whose wounds healed after an operation
93%
2019
92%
Home health patients with a hospital admission
16%
2019
15%
Home health patients with improved mobility
89%
2023
87%
Home health spending per Medicare beneficiary
$442
2023
$527
Long-stay nursing home residents with a hospital admission
18%
2020
17%
Nursing home residents with an antipsychotic medication
13%
2023
14.7%
Nursing home residents with pressure sores
9.8%
2023
7.8%
Short-stay nursing home residents with a 30-day readmission to the hospital
20%
2020
18%
Skilled nursing facility patients with a hospital readmission
21.7598%
2023
23.1493%
Skilled nursing facility spending per Medicare beneficiary
$717
2023
$875
Skilled nursing patients with a successful discharge
59%
2020
57%
Potentially Avoidable Care
Potentially Avoidable Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults with low back pain with an imaging study at diagnosis
58.7%
2023
63.2%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiaries
30.6
2023
35
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
2.8
2023
2.9
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
149.4
2023
155.2
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
155.3
2023
151.4
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
29.6
2023
30.6
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
4.7
2023
4.6
Preventive and Well Care
Preventive and Well Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
78.2%
2020
75.8%
Adult women who received a mammogram
82.2%
2024
79.5%
Adult women who received a recommended cervical cancer screening test
88%
2024
83.1%
Adults ages 45–74 who received a colon cancer screening test
72.4%
2024
70.5%
Adults who received a colon cancer screening test
75.6%
2020
72.4%
Adults with a recent flu shot
42.5%
2024
40.5%
Adults with age- and gender-appropriate cancer screenings
71.9%
2020
68.8%
Adults with age- and gender-appropriate cancer screenings (2022 update)
76.2%
2024
72.9%
Adults with age-appropriate vaccines
40.1%
2024
37.8%
Adults without a dental visit
34.2%
2024
33.9%
At risk adults with a recent check-up
92.3%
2024
91.9%
Children with a medical and dental preventive care visit in the past year
72.4%
2022-23
67.6%
Children with all recommended vaccines
76.8%
2023
69.5%
Diabetic adults with an annual hemoglobin A1c test
94.7%
2023
91.4%
Diabetic adults with an annual LDL-C test
85.8%
2023
80.6%
Older adults who received the pneumonia vaccine
72%
2024
70.3%
Premature avoidable deaths per 100,000 population
307.8
2022-23
277.5
Premature deaths from preventable causes per 100,000 population
213.4
2022-23
191.8
Premature deaths from treatable causes per 100,000 population
94.4
2022-23
85.7
Primary care spending as share of total, age 65 and older
6.8%
2023
5.7%
Primary care spending as share of total, ages 18–64
8.7%
2023
6.8%
Primary care spending per beneficiary, age 65 and older
$765
2023
$740
Primary care spending per enrollee, ages 18–64
-
2023
-
Public health funding
$15
2019
$40
Primary Health Care
Primary Health Care
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adult women who received a cervical cancer screening Pap test
78.2%
2020
75.8%
Adult women who received a mammogram
82.2%
2024
79.5%
Adults who received a colon cancer screening test
75.6%
2020
72.4%
Adults with a usual source of care
82.3%
2024
83.1%
Adults with age- and gender-appropriate cancer screenings
71.9%
2020
68.8%
Adults with age- and gender-appropriate cancer screenings (2022 update)
76.2%
2024
72.9%
Adults with age-appropriate vaccines
40.1%
2024
37.8%
At risk adults with a recent check-up
92.3%
2024
91.9%
Children with a medical and dental preventive care visit in the past year
72.4%
2022-23
67.6%
Children with a medical home
52.2%
2022-23
43.8%
Children with all recommended vaccines
76.8%
2023
69.5%
Diabetic adults with an annual hemoglobin A1c test
94.7%
2023
91.4%
Diabetic adults with an annual LDL-C test
85.8%
2023
80.6%
Doctors' office visit employer-sponsored insurance spending per enrollee
$674
2023
$608
Doctors' office visit spending per Medicare beneficiary
$1,092
2023
$1,155
Mortality amenable to health care, deaths per 100,000 population
90.6
2019-20
86.8
Older adults who received the pneumonia vaccine
72%
2024
70.3%
Premature avoidable deaths per 100,000 population
307.8
2022-23
277.5
Premature deaths from preventable causes per 100,000 population
213.4
2022-23
191.8
Premature deaths from treatable causes per 100,000 population
94.4
2022-23
85.7
Primary care spending as share of total, age 65 and older
6.8%
2023
5.7%
Primary care spending as share of total, ages 18–64
8.7%
2023
6.8%
Primary care spending per beneficiary, age 65 and older
$765
2023
$740
Primary care spending per enrollee, ages 18–64
-
2023
-
Working Age Adults
Working Age Adults
Indicator
Latest
The values below are from the most recent year or time period available for the indicator. Hover over the value to see the year or time period.
U.S. Avg.
Adults who are obese
36.2%
2024
34.3%
Adults who have lost six or more teeth
8.9%
2024
8.1%
Adults with low back pain with an imaging study at diagnosis
58.7%
2023
63.2%
Antidepressant use and adherence for depression
27%
2023
29.6%
Appropriate antibiotic among adults with bacterial pneumonia
48%
2023
41.3%
Diabetic adults with an annual hemoglobin A1c test
94.7%
2023
91.4%
Diabetic adults with an annual LDL-C test
85.8%
2023
80.6%
Doctors' office visit employer-sponsored insurance spending per enrollee
$674
2023
$608
Employee contribution to total premium cost for employer-sponsored health insurance plans
$5,731
2023
$5,510
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
7.9%
2023
6.8%
Employee deductible for employer-sponsored health insurance plans
$3,651
2023
$3,259
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
5%
2023
4%
Employee total potential out-of-pocket medical costs
$9,382
2023
$8,769
Employee total potential out-of-pocket medical costs, as a share of state median income
13%
2023
10.8%
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
2.8
2023
2.9
Inpatient employer-sponsored insurance spending per enrollee
$1,223
2023
$1,470
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
155.3
2023
151.4
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
4.7
2023
4.6
Primary care spending as share of total, ages 18–64
8.7%
2023
6.8%
Primary care spending per enrollee, ages 18–64
-
2023
-
Total employer-sponsored insurance spending per enrollee
$6,252
2023
$6,437
Total premium cost for employer-sponsored health insurance plans
$18,765
2023
$19,799
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
25.9%
2023
24.4%
Uninsured adults
12.1%
2024
11.3%
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North Carolina Policy Information

Policy
Status
Medicaid Expansion Status

Traditionally expanded Medicaid (33 states + DC)

Health Insurance Marketplace Type

Federally facilitated marketplace (17)

Public Coverage Options

Has not established a public coverage option

ACA Non-compliant Short-term Plans

Does not limit the sale of short-term coverage more strictly than the federal government

ACA Non-compliant Transitional Plans

Permits non-compliant transitional policies

Annual Open Enrollment Period Extensions

Did not extend 2018–2022 open enrollment

Health Coverage Subsidies

Provides no additional premium or cost-sharing subsidies

Other ACA Non-compliant Plans

Does not exempt other coverage from insurance rules

Promotion of ACA Marketplace Competition

No rules to promote marketplace competition

Standardized Individual Market Plans

Does not require standardized cost-sharing plan design

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North Carolina Key Demographics

10.6M
Total Population
$69.7K
Median Household Income
30%
Below 200% of Federal Poverty Level (FPL)
60%
% White race, non-Hispanic
20%
% Black race, non-Hispanic
11%
% Hispanic ethnicity
3%
% Asian American, Native Hawaiian, or Pacific Islander race, non-Hispanic
1%
% American Indian or Alaska Native race, non-Hispanic