Our new Medicare state scorecard gives federal and state policymakers a benchmark for how well Medicare serves people in every state.

Medicare Scorecard Shows State-by-State Variation in Beneficiary Experiences

October 16, 2025

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With Medicare’s annual open enrollment underway, a new Commonwealth Fund report finds dramatic differences in how beneficiaries across states experience the program — from provider access to the affordability of care.

The new State Scorecard on Medicare Performance ([link removed] ) shows that while Medicare is a federal program, factors such as the strength of a state’s health care system and the coverage provided by Medicare private plans can have a major impact on how well the program serves people.

Among the report’s findings:

- Vermont, Utah, and Minnesota rank highest overall, while Louisiana, Mississippi, and Kentucky ranked lowest.
- Preventable hospitalizations differ sharply by state. Idaho’s rate, the lowest, is less than half the rates in West Virginia, Massachusetts, and Alabama.
- Out-of-pocket spending on prescription drugs also varies widely, with beneficiaries in New York paying a far smaller share of their drug costs than those in North Dakota.

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Affordable, quality health care. For everyone.

The Commonwealth Fund, 1 East 75th Street, New York, NY 10021

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