As a companion to the 2009 State Scorecard, this report profiles seven health systems: six that rank among the top quartile of states--Vermont, Hawaii, Iowa, Minnesota, Massachusetts, and Wisconsin--plus Delaware, which was among the most-improved states from 2007 to 2009. These states demonstrate that high levels of health system performance are achievable and sustainable, and provide useful examples of state policies and practices that may be reasonably associated with health system improvement: a long-term commitment to reform, collaboration among stakeholders, leadership to expand health insurance coverage, transparency of health information, and a capacity to act on emerging best practices. The State Scorecard and this report also show that all states can aim higher in health system performance: if all states improved performance to the levels achieved by the best states, then thousands of lives could be saved and significant cost savings and improved health outcomes could be achieved.
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