New York, NY -- States vary widely in the quality of health care children receive, as well as children's access to care, family insurance premiums, equity, and the potential to lead long healthy, productive lives, according to a new scorecard issued by The Commonwealth Fund. The scorecard is the first report to assess how the health system is performing for children across these five dimensions on a state-by-state basis.

The striking differences across states add up to real consequences for children and their families. The report estimates that if all states performed as well as the top states:

-An additional 4.6 million children nationwide would have health insurance;

-11.8 million more children would get their recommended yearly medical and dental check-ups;
-1.6 million fewer children would be at risk for developmental delays;
-10.9 million more children would have a medical home; and
-Nearly 800,000 more children would be up-to-date on their vaccines.

The report, U.S. Variations In Child Health System Performance: A State Scorecard, by Commonwealth Fund researchers Katherine Shea, M.P.H., Karen Davis, Ph.D., and Edward Schor, M.D., ranked states on 13 indicators for children grouped in categories that include access, quality, costs, equity, and healthy outcomes. While no single state performed at the top across all categories, some states far surpassed others. States in the Northeast and Upper Midwest often rank high in multiple areas. In contrast, states with the lowest rankings tend to be concentrated in the South and Southwest. However, there was room for improvement in even the highest ranked states, which fell short of established standards on some indicators.

The report compares each state to benchmarks that have already been achieved in one or more states, and notes that, because there are limited state-level data on many measures of children's health, there is a pressing need for better data to inform federal and state health policy reform efforts.

"In looking at the country as a whole, we found that, while there are pockets of excellence, there is no one state or region that is doing as well as it could be," said co-author and Commonwealth Fund Vice President Edward Schor, M.D. "This scorecard points to the need to make more information available about children's health care and to improve the health care system for children. The good news is we know improvements can be made because we didn't judge these states based on a pie in the sky standard; we judged them against one another."
Access to Care for Children Consistent Among Top Scorers

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