Best and Worst States for Health Care in the US in 2025 (2025)

DGByDeb Gordon
Edited byVictoria Copans

Updated: February 7, 2025

Advertising & Editorial Disclosure

Access to health care services and the affordability of health insurance are crucial to overall health but vary widely across the United States. MoneyGeek analyzed a host of statistics, from health outcomes — such as deaths and rates of certain diseases or risk factors — to health access and cost — such as how many people are uninsured and have low-cost health insurance options available — to find the best and worst states for health care in 2024.

KEY FINDINGS:

  • Rhode Island is the top state for health care in the U.S. Its residents enjoy convenient access to medical services, securing the top spot for accessibility.

  • West Virginia has the worst health care in the nation. Though West Virginia ranks No. 2 for accessibility, it has the worst health outcomes of any state, with the highest mortality rate (1,116 deaths per 100,000 residents) and diabetes mortalities. It also has the fourth-highest average private health insurance premiums ($10,563 per year) in the U.S.

  • Maryland has the lowest annual private health insurance premiums of any state ($4,606, on average). The national average annual cost across all states in the U.S. is $7,083

  • New York and Alaska have the highest private health insurance premiums, both over $11,000 annually.

  • Utah and Wyoming have the most cost-effective health care systems in the U.S., delivering the best returns on health care quality for every 1% of state GDP spent on health care assistance.

States With the Best (and Worst) Health Care

Best and Worst States for Health Care in the US in 2025 (2)

The states with the best health care in the United States are those where people are generally healthier, have access to health care services and are less likely to be uninsured. The best states for health care are found all across the country, from Hawaii to Rhode Island. That said, four of the top 10 states on our list are located in the Northeast, while three are in the West.

States that fare worse on our health care rankings tend to have higher costs for less access and higher rates of medical conditions like diabetes and obesity. The worst states for health care are concentrated regionally, with eight of the 10 clustered in the South and Southeast.

The Top 10 States for Health Care

State

Score

Region

1.

Rhode Island

100.0

Northeast

2.

Hawaii

97.5

West

3.

New Hampshire

92.7

Northeast

4.

Minnesota

90.1

Midwest

5.

Colorado

79.4

West

6.

Washington

78.6

West

7.

Iowa

77.4

Midwest

8.

New Jersey

75.6

Northeast

9.

Maryland

75.4

South

10.

Massachusetts

74.8

Northeast

The 10 Worst States for Health Care

State

Score

Region

1.

West Virginia

0.0

South

2.

Alaska

1.3

West

3.

Louisiana

11.5

South

4.

Oklahoma

12.0

South

5.

Mississippi

13.3

South

6.

Tennessee

16.3

South

7.

Missouri

17.8

Midwest

8.

New Mexico

18.9

West

9.

North Carolina

22.4

South

10.

South Dakota

25.9

Midwest

Additional Findings: Outcome, Cost and Access Data Rankings

To evaluate health care in the United States, MoneyGeek looked at three categories of data that together create a comprehensive view of the overall quality of health care in each location. Those categories include:

  • Health outcomes, including indicators such as rates of disease and risk factors like obesity and smoking, preventable deaths and infant mortality. These measures help answer the question: How healthy are the people who live here?

  • Cost, including factors like how much the state spends on health care, the average cost of private health insurance, and the return on health care quality per 1% of state GDP spent. These measures help answer the questions: How expensive is health care in this state, and how effectively is state spending translating into quality care?

  • Access, including data on the number of primary care providers and hospital beds available, how many people are uninsured and how many people needed care but had difficulty getting it. These indicators help answer the question: How easy is getting the health care you need in this state?

Within these three categories, we broke down the best and the worst states across various health care outcome, cost and access data points. Below is a summary of those findings and the best and worst states for each data point.

Deep Blue States Across the US Have the Healthiest Residents

Best and Worst States for Health Care in the US in 2025 (3)

Best States for Health Outcomes:
1. Massachusetts
2. Hawaii
3. New Jersey
4. California
5. New Hampshire

Best and Worst States for Health Care in the US in 2025 (4)

Worst States for Health Outcomes:
1. West Virginia
2. Mississippi
3. Louisiana
4. Arkansas
5. Oklahoma

Southern States Have Highest Diabetes Mortality Rates

Best and Worst States for Health Care in the US in 2025 (5)

States With Fewest Diabetes Deaths per 100,000 Residents:
1. Connecticut: 15.2
2. Massachusetts: 16.1
3. Hawaii: 17.2
4. New Jersey: 17.3
5. New York: 18.2

Best and Worst States for Health Care in the US in 2025 (6)

States With Most Diabetes Deaths per 100,000 Residents:
1. West Virginia: 41.1
2. Arkansas: 36
3. Mississippi: 34.7
4. Oklahoma: 33.8
5. Tennessee: 31.2

West Virginia’s Mortality Rate Is Nearly Double Hawaii’s

Best and Worst States for Health Care in the US in 2025 (7)

States With the Lowest Mortality Rate per 100,000 Residents:
1. Hawaii: 616
2. New York: 665
3. New Jersey: 684
4. California: 686
5. Massachusetts: 694

Best and Worst States for Health Care in the US in 2025 (8)

States With the Highest Mortality Rate per 100,000 Residents:
1. West Virginia: 1,116
2. Mississippi: 1,073
3. Kentucky: 1,044
4. Alabama: 1,026
5. Tennessee: 1,009

Healthcare Spending Efficiency is Best in the West and Midwest

Best and Worst States for Health Care in the US in 2025 (9)

States With the Most Cost-Effective Health Care Systems:
1. Utah
2. Wyoming
3. Iowa
4. Colorado
5. Nebraska

Best and Worst States for Health Care in the US in 2025 (10)

States With the Least Cost-Effective Health Care Systems:
1. Arizona
2. West Virginia
3. Maine
4. Montana
5. Vermont

States With Costliest Health Insurance Are Twice as Expensive as the 5 Cheapest States

Best and Worst States for Health Care in the US in 2025 (11)

States With Lowest Average Cost of Private Health Insurance:
1. Maryland: $4,606
2. Virginia: $4,993
3. Minnesota: $5,085
4. Indiana: $5,256
5. Rhode Island: $5,372

Best and Worst States for Health Care in the US in 2025 (12)

States With Highest Average Cost of Private Health Insurance:
1. New York: $18,396
2. Alaska: $11,131
3. Vermont: $10,894
4. West Virginia: $10,563
5. Wyoming: $9,721

Access to Care Varies Widely Across Regions

Best and Worst States for Health Care in the US in 2025 (13)

Best States for Access to Care:
1. Rhode Island
2. West Virginia
3. Iowa
4. Ohio
5. Vermont

Best and Worst States for Health Care in the US in 2025 (14)

Worst States for Access to Care:
1. Nevada
2. Arizona
3. Alaska
4. Georgia
5. Texas

Northeast States Have Lowest Uninsured Rates; Southern States, Highest

Best and Worst States for Health Care in the US in 2025 (15)

States With Lowest Uninsured Population Rate:
1. Massachusetts: 2.4%
2. Hawaii: 3.5%
3. Vermont: 3.9%
4. Rhode Island: 4.2%
5. Iowa: 4.5%

Best and Worst States for Health Care in the US in 2025 (16)

States With Highest Uninsured Population Rate:
1. Texas: 16.6%
2. Oklahoma: 11.7%
3. Georgia: 11.7%
4. Wyoming: 11.6%
5 Florida: 11.2%

Northeast States Have Double the Primary Care Providers of Western States

Best and Worst States for Health Care in the US in 2025 (17)

States With the Most Primary Care Providers per 100,000 Residents:
1. Massachusetts: 231.8
2. Rhode Island: 211.9
3. New York: 211.4
4. Maryland: 204.4
5. Connecticut: 202.8

Best and Worst States for Health Care in the US in 2025 (18)

States With the Fewest Primary Care Providers per 100,000 Residents:
1. Nevada: 104.5
2. Idaho: 109
3. Utah: 113.8
4. Texas: 116.4
5. Mississippi: 121.4

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Methodology

To explore and rank health care quality by state, MoneyGeek analyzed three core categories — health outcomes, cost and access to care — using health care data from the Kaiser Family Foundation, the Centers for Disease Control and HealthData.gov. We assigned weights to each factor within these core categories to measure health care quality. We used the 2023 data for New York's average private annual health insurance premiums due to the unavailability of 2024 data.

MoneyGeek used the following metrics in our analysis:

  • Mortality rate: Full weight
  • Infant mortality rate: Full weight
  • Life expectancy: Half weight
  • Diabetes deaths per 100,000 people: Half weight
  • Obesity as a percentage of the population: Half weight
  • Hospital inpatient stays involving opioid-related diagnoses per 100,00 people: Quarter weight
  • Smoking rate among adults: Quarter weight
  • Suicide deaths among persons ages 12 and older per 100,000 people: Quarter weight
  • New HIV cases among persons ages 13 and older per 100,000 people: Quarter weight
  • Annual health insurance costs: Double weight
  • Average Performance Score Per one percent of GDP Spent: Full weight
  • Health care spending as a percentage of state GDP: Half weight
  • Health care spending as a share of GDP per resident: Half weight
  • Percentage of population with health insurance: Full weight
  • Number of hospital beds per 100,000 people: Half weight
  • Adults who had a doctor's office or clinic visit in the last 12 months and needed care, tests, or treatment who sometimes or never found it easy to get the care, tests, or treatment, Medicare fee-for-service: Quarter weight
  • Adults who needed to see a specialist in the last six or 12 months who sometimes or never found it easy to see a specialist, Medicare fee-for-service: Quarter weight
  • Primary care health professional shortage areas: % of need met to remove shortage designation: Quarter weight
  • Number of primary care providers per 100,000 population: Quarter weight

Full Dataset

The data points presented are defined as follows:

Rank: Based on the “Final Score” ranging from 1-100

Final Score: Cumulative total of Outcome, Cost and Access scores

  1. Outcome Factor Rank: Based on cumulative scores across the following factors:
    • Infant mortality rate: The number of infant deaths per 1,000 live births
    • Preventable death rate: Deaths that can be avoided through effective preventative health care and interventions per 100,000 residents
    • Diabetes mortality rate: Deaths attributed to diabetes per 100,000 residents
    • Obesity: Percentage of population considered obese
    • Smoking rate: Percentage of adults who reported smoking
    • Life expectancy: The average number of years a person can expect to live
    • Suicide rates: Suicide deaths among persons age 12 and over per 100,000 residents
    • New HIV cases per 100,000 residents over the age of 13
    • Opioid-related hospital stay rate: Inpatient hospital stays involving opioid-related diagnoses per 100,000 residents
  2. Cost Factor Rank: Based on cumulative scores across the following factors:
    • Health care spending as a percentage of state GDP: Government spending on health care and social assistance out of total state GDP
    • State government spending on health care and social assistance per resident
    • Average annual private health insurance premium costs
    • Quality of Care Per 1% of GDP Spent: Calculated by dividing the quality of care score by health care spending as a percentage of the state’s GDP. The quality score is based on AHRQ, which grades health care quality across several health measures in categories. We then converted these grades into a numeric scale and averaged these scores across the state.
  3. Access Factor Rank: Based on cumulative score across the following factors:
    • Number of hospital beds per 1,000 residents
    • Number of primary care providers per 100,000 residents
    • Primary care provider shortage areas (HPSAs) by state: Designations that identify areas of the U.S. experiencing health care professional shortages
    • Percentage of population with access to any insurance versus just health insurance
    • Ease of access to care at the doctor’s office or clinic using Medicare
    • Ease of access to care at a specialist using Medicare

State

Rank

FinalScore

Outcome Factor Rank (1st = Best)

Cost Factor Rank (1st = Lowest)

Access Factor Rank (1st = Best)

Hawaii

1

73.0

1

18

30

Rhode Island

2

68.0

10

40

2

Iowa

3

67.7

15

13

1

Massachusetts

4

67.4

3

46

5

Minnesota

5

67.0

11

35

6

New Hampshire

6

66.9

9

30

11

Colorado

7

66.8

8

3

33

Vermont

8

66.6

2

49

13

Connecticut

9

64.5

6

44

16

New Jersey

10

63.6

5

41

31

California

11

63.5

4

22

43

Washington

12

62.7

12

11

41

Virginia

13

62.5

22

2

26

Utah

14

61.5

14

1

39

Wisconsin

15

61.3

16

37

10

Illinois

16

60.9

18

25

21

Nebraska

17

60.4

17

34

18

North Dakota

18

60.4

19

33

12

Oregon

19

59.9

13

27

34

Maryland

20

57.8

23

15

35

Delaware

21

57.6

21

29

29

Idaho

22

57.4

20

9

42

Pennsylvania

23

57.3

25

43

8

Michigan

24

57.3

35

19

9

Kansas

25

57.0

32

23

15

New York

26

55.9

7

50

17

Maine

27

55.4

26

42

24

Wyoming

28

53.5

30

12

44

Montana

29

53.3

24

39

37

Florida

30

52.6

29

28

40

Ohio

31

52.4

42

31

4

South Carolina

32

52.4

40

6

32

Indiana

33

51.8

41

24

19

Missouri

34

51.0

37

36

27

Nevada

35

50.5

28

8

50

North Carolina

36

50.2

38

20

36

Georgia

37

50.1

36

5

45

South Dakota

38

50.1

34

47

23

Texas

39

49.9

31

7

49

Arizona

40

49.9

27

32

46

Alabama

41

48.0

45

10

22

Kentucky

42

47.4

47

21

7

Arkansas

43

46.6

46

16

20

Tennessee

44

45.6

43

38

25

New Mexico

45

45.2

39

17

48

Oklahoma

46

44.6

44

14

38

Louisiana

47

44.4

48

26

14

Alaska

48

44.2

33

45

47

Mississippi

49

42.1

49

4

28

West Virginia

50

35.4

50

48

3

About Deb Gordon

Best and Worst States for Health Care in the US in 2025 (19)

Deb Gordon, the co-founder and CEO of Umbra Health Advocacy, has held executive roles in health insurance and health care technology services. She authored a book titled “The Health Care Consumer’s Manifesto,” based on her research as a senior fellow at Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government. Her works have been published on JAMA Network Open, Harvard Business Review blog, USA Today and RealClear Politics, among others.

Gordon is an Aspen Institute Health Innovators Fellow and an Eisenhower Fellow. She was a 2011 Boston Business Journal 40 Under 40 honoree and a volunteer at MIT’s Delta V start-up accelerator, the Fierce Healthcare Innovation Awards. She earned her bioethics degree from Brown University and her MBA with distinction from Harvard Business School.

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