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Pennsylvania

A collection of resources on health system performance in Pennsylvania.

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Featured Performance Indicators

8%

Uninsured adults
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82

Mortality amenable to health care, deaths per 100,000 population
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127

Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
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Pennsylvania 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
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
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
7.9%
2020
10.7%
Adults with a usual source of care
85%
2020
76.8%
Adults with any mental illness reporting unmet need
26%
2018-19
25%
Adults with any mental illness who did not receive treatment
52%
2018-19
56%
Adults without a dental visit
31.9%
2020
35.3%
Children who received needed mental health care
87.6%
2019-20
81.3%
Children with a medical and dental preventive care visit in the past year
72.8%
2019-20
65.7%
Children with a medical home
47.3%
2019-20
46.8%

Children

Children
Indicator
Latest
U.S. Avg.
Children who are overweight or obese
29.5%
2019-20
32.1%
Children who received needed mental health care
87.6%
2019-20
81.3%
Children with a medical and dental preventive care visit in the past year
72.8%
2019-20
65.7%
Children with a medical home
47.3%
2019-20
46.8%
Children with all recommended vaccines
79%
2020
73%
Infant mortality per 1,000 live births
5.9
2019
5.6
Uninsured children
5.9%
2020
5.4%
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
7.9%
2020
10.7%
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,383
2020
$4,813
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
6%
2020
6.9%
Employee deductible for employer-sponsored health insurance plans
$2,793
2020
$3,257
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
3.8%
2020
4.7%
Employee total potential out-of-pocket medical costs
$7,176
2020
$8,070
Employee total potential out-of-pocket medical costs, as a share of state median income
9.8%
2020
11.6%
Individuals with high out-of-pocket medical spending
5.1%
2019-20
7.3%
People with medical debt
11.5%
2020
14.6%
Total premium cost for employer-sponsored health insurance plans
$16,563
2020
$17,193
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
22.6%
2020
24.6%
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
$488
2019
$517
Doctors' office visit spending per Medicare beneficiary
$917
2020
$910
Home health spending per Medicare beneficiary
$447
2020
$507
Inpatient employer-sponsored insurance spending per enrollee
$1,434
2019
$1,375
Inpatient spending per Medicare beneficiary
$2,540
2020
$2,488
Primary care spending as share of total, age 65 and older
5.3%
2020
5.5%
Primary care spending as share of total, ages 18–64
6.1%
2019
7.2%
Primary care spending per beneficiary, age 65 and older
$644
2020
$702
Primary care spending per enrollee, ages 18–64
$422
2019
$501
Public health funding
$15
2019
$40
Skilled nursing facility spending per Medicare beneficiary
$717
2020
$851
Total employer-sponsored insurance spending per enrollee
$5,174
2019
$5,354
Total spending per Medicare beneficiary
$9,502
2020
$9,677
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
8.2%
2020
12.4%
Uninsured children
5.9%
2020
5.4%
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
32.3%
2020
32.8%
Adults who have lost six or more teeth
8.3%
2020
8.5%
Adults who report fair or poor health
11.4%
2020
12.3%
Adults who smoke
15.8%
2020
14.3%
Alcohol deaths per 100,000 population
8.3
2020
13.1
Breast cancer deaths per 100,000 female population
19.6
2020
19.1
Children who are overweight or obese
29.5%
2019-20
32.1%
Colorectal cancer deaths per 100,000 population
13.4
2020
12.9
Deaths of despair (suicide, alcohol, and poisoning) per 100,000 population
-
No data available
-
Drug overdose deaths per 100,000 population
42.4
2020
28.3
Hospital 30-day mortality
12.9%
07/2017 - 12/2019
13.3%
Infant mortality per 1,000 live births
5.9
2019
5.6
Maternal mortality per 100,000 live births
15.5
2019-2020
21.9
Mortality amenable to health care, deaths per 100,000 population
82.1
2019-20
86.8
Premature avoidable deaths per 100,000 population
258.2
2019-20
259.1
Premature deaths from preventable causes per 100,000 population
174.2
2019-20
173.2
Premature deaths from treatable causes per 100,000 population
83.9
2019-20
85.9
Public health funding
$15
2019
$40
Suicide deaths per 100,000 population
12.6
2020
13.5
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)
51
2020
51
Central line-associated blood stream infection (CLABSI), Standardized Infection Ratio
0.849
2020
0.857
Communication about medicines (out of 100 points)
62
2020
63
Communication with doctors (out of 100 points)
80
2020
80
Communication with nurses (out of 100 points)
81
2020
79
Hospital 30-day mortality
12.9%
07/2017 - 12/2019
13.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
36.1
2020
33.2
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3.1
2019
3.1
Hospital discharge instructions for home recovery
88%
2020
86%
Hospital discharge planning and instructions for home recovery (out of 100 points)
88
2020
87
Hospitals with better-than-average patient experience ratings
44%
2020
48%
Patients' overall hospital experience (out of 100 points)
70
2020
71
Responsiveness of hospital staff (out of 100 points)
67
2020
66
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
26%
2018-19
25%
Adults with any mental illness who did not receive treatment
52%
2018-19
56%
Alcohol deaths per 100,000 population
8.3
2020
13.1
Antidepressant use and adherence for depression
58.8%
2019
45.3%
Children who received needed mental health care
87.6%
2019-20
81.3%
Deaths of despair (suicide, alcohol, and poisoning) per 100,000 population
-
No data available
-
Drug overdose deaths per 100,000 population
42.4
2020
28.3
Suicide deaths per 100,000 population
12.6
2020
13.5
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.
Doctors' office visit spending per Medicare beneficiary
$917
2020
$910
Home health patients with a hospital admission
18%
2019
15%
Home health spending per Medicare beneficiary
$447
2020
$507
Hospital 30-day mortality
12.9%
07/2017 - 12/2019
13.3%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
36.1
2020
33.2
Inpatient spending per Medicare beneficiary
$2,540
2020
$2,488
Long-stay nursing home residents with a hospital admission
12%
2016
15%
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
126.9
2020
137.1
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
32.2
2020
29.4
Primary care spending as share of total, age 65 and older
5.3%
2020
5.5%
Primary care spending per beneficiary, age 65 and older
$644
2020
$702
Short-stay nursing home residents with a 30-day readmission to the hospital
19%
2016
19%
Skilled nursing facility spending per Medicare beneficiary
$717
2020
$851
Total spending per Medicare beneficiary
$9,502
2020
$9,677
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
69.2%
2019
67.9%
Appropriate antibiotic among adults with bacterial pneumonia
81.1%
2019
57.2%
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 whose wounds healed after an operation
93%
2019
92%
Home health patients with a hospital admission
18%
2019
15%
Home health patients with improved mobility
81%
2019
80%
Home health spending per Medicare beneficiary
$447
2020
$507
Long-stay nursing home residents with a hospital admission
12%
2016
15%
Nursing home residents with an antipsychotic medication
15.4%
2020
14.4%
Nursing home residents with pressure sores
5%
2017
5.6%
Short-stay nursing home residents with a 30-day readmission to the hospital
19%
2016
19%
Skilled nursing facility spending per Medicare beneficiary
$717
2020
$851
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
69.2%
2019
67.9%
Hospital 30-day readmissions age 65 and older, per 1,000 Medicare beneficiares
36.1
2020
33.2
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3.1
2019
3.1
Potentially avoidable ED visits age 65 and older, per 1,000 Medicare beneficiaries
126.9
2020
137.1
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
102.5
2019
150.6
Preventable hospitalizations age 65 and older, per 1,000 Medicare beneficiaries
32.2
2020
29.4
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
6.7
2019
5.3
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.
Adults with age- and gender-appropriate cancer screenings
73.2%
2020
68.8%
Adults with age-appropriate vaccines
47.3%
2020
43.6%
Adults without a dental visit
31.9%
2020
35.3%
Children with a medical and dental preventive care visit in the past year
72.8%
2019-20
65.7%
Children with all recommended vaccines
79%
2020
73%
Diabetic adults with an annual hemoglobin A1c test
86.2%
2019
91.9%
Diabetic adults with an annual LDL-C test
78.5%
2019
80%
Premature avoidable deaths per 100,000 population
258.2
2019-20
259.1
Premature deaths from preventable causes per 100,000 population
174.2
2019-20
173.2
Premature deaths from treatable causes per 100,000 population
83.9
2019-20
85.9
Primary care spending as share of total, age 65 and older
5.3%
2020
5.5%
Primary care spending as share of total, ages 18–64
6.1%
2019
7.2%
Primary care spending per beneficiary, age 65 and older
$644
2020
$702
Primary care spending per enrollee, ages 18–64
$422
2019
$501
Public health funding
$15
2019
$40
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
32.3%
2020
32.8%
Adults who have lost six or more teeth
8.3%
2020
8.5%
Adults with low back pain with an imaging study at diagnosis
69.2%
2019
67.9%
Antidepressant use and adherence for depression
58.8%
2019
45.3%
Appropriate antibiotic among adults with bacterial pneumonia
81.1%
2019
57.2%
Diabetic adults with an annual hemoglobin A1c test
86.2%
2019
91.9%
Diabetic adults with an annual LDL-C test
78.5%
2019
80%
Doctors' office visit employer-sponsored insurance spending per enrollee
$488
2019
$517
Employee contribution to total premium cost for employer-sponsored health insurance plans
$4,383
2020
$4,813
Employee contribution to total premium cost for employer-sponsored health insurance plans, as a share of state median income
6%
2020
6.9%
Employee deductible for employer-sponsored health insurance plans
$2,793
2020
$3,257
Employee deductible for employer-sponsored health insurance plans, as a share of state median income
3.8%
2020
4.7%
Employee total potential out-of-pocket medical costs
$7,176
2020
$8,070
Employee total potential out-of-pocket medical costs, as a share of state median income
9.8%
2020
11.6%
Hospital 30-day readmissions ages 18–64, per 1,000 employer coverage enrollees
3.1
2019
3.1
Inpatient employer-sponsored insurance spending per enrollee
$1,434
2019
$1,375
Potentially avoidable ED visits ages 18–64, per 1,000 employer coverage enrollees
102.5
2019
150.6
Preventable hospitalizations ages 18–64, per 1,000 employer coverage enrollees
6.7
2019
5.3
Primary care spending as share of total, ages 18–64
6.1%
2019
7.2%
Primary care spending per enrollee, ages 18–64
$422
2019
$501
Total employer-sponsored insurance spending per enrollee
$5,174
2019
$5,354
Total premium cost for employer-sponsored health insurance plans
$16,563
2020
$17,193
Total premium cost for employer-sponsored health insurance plans, as a share of state median income
22.6%
2020
24.6%
Uninsured adults
8.2%
2020
12.4%
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Pennsylvania Policy Information

Policy
Status
Medicaid Expansion Status

Traditionally expanded Medicaid (31 states + DC)

Health Insurance Marketplace Type

State-based marketplace (17 plus DC)

The state is responsible for all marketplace functions, including health plan management, consumer assistance, eligibility and enrollment, financing, and marketing and outreach. The state manages its own marketplace website where individuals can enroll in coverage.

Public Coverage Options

Has not established a public coverage option

Annual Open Enrollment Period Extensions

Extended 2022 open enrollment

Extended 2022 open enrollment period through Jan. 15, 2022.

Did not extend the open enrollment period for 2018, 2019, or 2020 coverage. Extended the 2021 open enrollment period through Jan. 15, 2021 and also from Feb. 15, 2021 through Aug. 15, 2021.

Health Coverage Subsidies

Provides no premium or cost-sharing subsidies

Non-compliant Short-term Plans

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

Non-compliant Transitional Plans

Permits non-compliant transitional policies

Permits insurers to sell non-compliant transitional policies in the individual market

Other Non-compliant Plans

Does not exempt other coverage from insurance rules

Does not exempt other coverage products from federal and state rules for individual market insurance*

Promotion of ACA Marketplace Competition

No rules to promote marketplace competition

Has not established a rule to promote a competitive ACA marketplace

Standardized Individual Market Plans

Does not require standardized cost-sharing plan design

Does not require participating individual market insurers to offer plans with standardized cost-sharing designs

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Pennsylvania Key Demographics

12.6M
Total Population
$64.6K
Median Household Income
26%
Below 200% of Federal Poverty Level (FPL)
74%
% White race, non-Hispanic
10%
% Black race, non-Hispanic
8%
% Hispanic ethnicity
3%
% Asian American, Native Hawaiian, or Pacific Islander race, non-Hispanic
< 1%
% American Indian or Alaska Native race, non-Hispanic