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
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 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.
