Top States for Cancer Care in the U.S.

ValuePenguin created a Care Score to analyze the top states for cancer care, considering the potential cost of treatment, access to care and death rates. Minnesota scored the highest, while three states — Wisconsin, Georgia and Oklahoma — tied at the bottom, according to our Care Score metric.

No matter a patient’s location, there are strong and weak attributes of local cancer care. However, ValuePenguin found some similar traits among the lowest-scoring states: high out-of-pocket maximums and the inability to qualify for cost savings on marketplace health care insurance.

Key findings

• Minnesota tops our list of states with the best cancer care. The state has low average costs of health insurance and the best access to medical care.
• Georgia, Oklahoma and Wisconsin placed at the bottom of our evaluation, due to the high cost of insurance and limited access to public health coverage.
• In 21 states, the cheapest health insurer has the highest legally allowed out-of-pocket maximum. Just one of those states was in our top 10 for highest Care Scores.

States with low health insurance costs were our most consistent high performers

To measure affordability, ValuePenguin found the cheapest premiums for a Silver health insurance plan in each state and sorted those according to an even distribution across all 50 states.

The maximum number of points a state could earn was 20. Although no state earned a perfect Care Score, Minnesota’s score of 19 was the highest. Five states — New Mexico, Rhode Island, Arizona, Maryland and Pennsylvania — placed just below Minnesota at 18, and California earned a 17.

These states — along with Michigan, which earned a 16 — all have among the cheapest monthly health insurance premiums compared to the rest of the U.S. In fact, of the top 10 high scorers, just two — Montana and Alaska — fall outside of the range of the cheapest health insurance premiums.

Moreover, the highest-scoring states — except for Montana, New Mexico and California — combine cheap health insurance with low out-of-pocket maximums. This refers to the highest amount policyholders would have to pay for covered services — including payments toward deductibles, coinsurance and copays — before all costs are covered by the insurer. Since insurers can’t set a lifetime or yearly spending limit on the coverage they provide, the out-of-pocket maximum tells the policyholder the maximum amount they could pay in cost sharing.

Finally, the best-scoring states for cancer care all have expanded Medicaid eligibility. In these states, some people with low incomes who wouldn’t normally qualify for Medicaid or marketplace tax credits can receive cheap health coverage and, ultimately, treatment if they develop cancer. Under expanded Medicaid laws, more patients would have access to cancer treatments.

Care Score	State	Cheapest monthly premium	Out-of-pocket maximum
19	Minnesota	$265	$6,800
18	New Mexico	$313	$8,500
	Maryland	$339	$6,650
	Arizona	$330	$7,750
	Pennsylvania	$343	$6,900
	Rhode Island	$328	$6,750
17	California	$325	$8,200
	Montana	$356	$8,550
16	Michigan	$292	$6,500
	Alaska	$658	$6,000

Health insurance costs and out-of-pocket maximums in the lowest-scoring states

On the other end, no state earned a Care Score lower than nine. Wisconsin, Georgia and Oklahoma were the lowest-scoring states for cancer care. Unlike in the best-scoring states, affordability is an issue in these states. The cheapest health insurance providers in Georgia and Oklahoma had some of the more expensive premiums in the U.S. These two, along with Wisconsin, haven’t implemented expanded Medicaid — though Oklahoma is set to expand later in 2021. Finally, in each of these three states, the out-of-pocket maximum sits at $8,550, the maximum amount allowed by law.

Care Score	State	Cheapest monthly premium	Out-of-pocket maximum
9	Oklahoma	$476	$8,550
	Georgia	$416	$8,550
	Wisconsin	$343	$8,550
10	Missouri	$413	$8,550
	Wyoming	$647	$8,550
	West Virginia	$508	$8,550
	Mississippi	$419	$8,400
	North Carolina	$373	$8,550
	Texas	$381	$8,550
	Tennessee	$428	$7,300

Utah has the lowest cancer death rate and Idaho has the highest number of hospitals per population, but neither is in our top 10

In addition to affordability, ValuePenguin’s Care Score takes into account cancer death rates and hospitals per 100,000 people. According to the most recent data from the Centers for Disease Control and Prevention (CDC), the average death rate from cancer across the 50 states is 152 per 100,000 people. The average rate among the 10 top-scoring states is 145 per 100,000, but the best states don’t score uniformly well by this metric.

Three of the 10 states with the highest Care Scores — Michigan, Pennsylvania and Rhode Island — fall in the lowest or second-lowest tier (highest death rates), according to our analysis. Michigan, in fact, ranks in the lowest tier for cancer deaths per 100,000 people, but its low health insurance premiums and out-of-pocket maximums help it overcome this deficit.

Similarly, just three states among the top 10 for cancer care ranked well for hospital access. Minnesota, New Mexico and Montana placed in the highest tier for hospital access. In these states, there are an average of 6.6 hospitals per 100,000 residents. Comparatively, in Rhode Island and Pennsylvania, this number slips beneath three, and in California and Arizona, this number is below four.

Care Score	State	Cheapest monthly premium	Out-of-pocket maximum	Medicaid expansion	Death rate	Hospitals per 100,000 people
19	Minnesota	$265	$6,800	Yes	143.1	5.8
18	New Mexico	$313	$8,500	Yes	136.4	6.2
18	Maryland	$339	$6,650	Yes	149.9	4.8
18	Arizona	$330	$7,750	Yes	131.9	3.5
18	Pennsylvania	$343	$6,900	Yes	156.6	2.9
18	Rhode Island	$328	$6,750	Yes	151.6	2.5
17	California	$325	$8,200	Yes	135	3.9
16	Montana	$356	$8,550	Yes	140.7	8.0
16	Michigan	$292	$6,500	Yes	161.1	5.4
16	Alaska	$658	$6,000	Yes	141.5	4.6
15	Idaho	$467	$8,150	Yes	149.5	10.7
15	Nebraska	$527	$8,150	Yes	150.5	8.1
15	Washington	$344	$7,350	Yes	145.3	2.7
14	North Dakota	$400	$8,550	Yes	145.2	9.6
14	Hawaii	$467	$8,500	Yes	123.5	5.1
14	Kentucky	$406	$6,850	Yes	181.6	4.6
14	Arkansas	$387	$8,400	Yes	168.8	4.6
14	Indiana	$329	$8,400	Yes	165.7	4.5
14	Ohio	$311	$8,400	Yes	165.2	3.8
14	Maine	$392	$7,800	Yes	162.1	3.6
14	New Hampshire	$325	$8,500	Yes	143.7	3.5
14	Colorado	$278	$8,550	Yes	127.6	2.7
13	Iowa	$457	$8,550	Yes	155.3	7.9
13	South Carolina	$391	$8,400	No	157.3	6.3
13	Massachusetts	$344	$8,550	Yes	142.8	4.3
13	Vermont	$574	$6,700	Yes	156	3.8
13	Utah	$443	$8,550	Yes	120	3.8
13	Virginia	$392	$8,550	Yes	149.3	3.6
13	Connecticut	$479	$8,150	Yes	134.1	3.2
13	New York	$473	$8,500	Yes	138.2	2.1
13	New Jersey	$388	$8,550	Yes	141.3	2.0
12	Louisiana	$407	$8,550	Yes	169	9.4
12	South Dakota	$473	$8,150	No	145.2	8.6
12	Kansas	$441	$8,400	No	156.4	7.4
12	Alabama	$509	$8,150	Yes	170.4	4.8
12	Illinois	$337	$8,550	Yes	153.5	3.3
12	Delaware	$522	$6,900	Yes	159.4	3.2
12	Nevada	$352	$8,550	Yes	146.5	2.7
11	Florida	$408	$8,550	No	141.7	4.6
11	Oregon	$402	$8,550	Yes	150.6	2.3
10	Missouri	$413	$8,550	Not implemented	165.3	6.0
10	Wyoming	$647	$8,550	No	140.6	5.5
10	West Virginia	$508	$8,550	Yes	179.5	5.4
10	Mississippi	$419	$8,400	No	179.7	5.0
10	North Carolina	$373	$8,550	No	154.2	4.9
10	Texas	$381	$8,550	No	142.9	4.0
10	Tennessee	$428	$7,300	No	168	4.0
9	Oklahoma	$476	$8,550	Not implemented	178.1	6.0
9	Georgia	$416	$8,550	No	152.4	4.6
9	Wisconsin	$343	$8,550	No	151.5	3.3

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Among the lowest-scoring states, the death rate from cancer is comparatively high. Of the 10 lowest-scoring states, half have death rates from cancer that fall into the lowest tier (highest death rates). Another three states in the bottom 10 fall in the second-lowest tier, according to our metric. Only Wyoming is among the states with the lowest death rates, though the state’s high cost of insurance, out-of-pocket maximums and narrow Medicaid eligibility access prevent it from performing better.

By comparison, the average number of hospitals per 100,000 people in the lowest-scoring states improves. In only one of these states, Wisconsin, the number of hospitals falls under four per 100,000 people. The states with the lowest Care Scores are more likely to have enough hospitals relative to their populations to qualify for the second-highest tier. However, despite the high scores, they’re unable to overcome their high out-of-pocket maximums and poor access to Medicaid.

States without expanded Medicaid see higher rates of uninsured people, and less access to health care

According to data from the Office of Disease Prevention and Health Promotion, 88% of people in the U.S. claim to have access to an ongoing source of health care. This number drops to 79% for 25- to 44-year-olds and 52% for those without any form of health insurance coverage.

Although ValuePenguin didn’t factor in the number of uninsured residents when calculating Care Scores, it’s important to note that a widespread lack of insurance would lower the number of people who could get treatment for any disease, including cancer, especially in states without expanded Medicaid.

Indeed, there are 17 states that have a higher-than-average percentage of uninsured residents. Of these states, 10 don’t have expanded Medicaid. Of the states without expanded Medicaid, only Tennessee, Wisconsin and Missouri, which hasn’t yet implemented its expansion, have an average or below-average percentage of uninsured residents.

State	Percentage of population uninsured	Expanded Medicaid?
Texas	11%	No
Oklahoma	9%	Not implemented
Alabama	8%	Yes
Nevada	8%	Yes
North Carolina	8%	No
Wyoming	8%	No
Alaska	7%	Yes
Georgia	7%	No
Idaho	7%	Yes
Mississippi	7%	No
South Carolina	7%	No
Florida	6%	No
Hawaii	6%	Yes
Kansas	6%	No
New Mexico	6%	Yes
South Dakota	6%	No
Washington	6%	Yes

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Methodology

ValuePenguin developed a Care Score to evaluate the affordability and performance of states when it comes to cancer care. This score combines a state’s position relative to other states in five areas:

• Cheapest health insurance premium
• Out-of-pocket maximum
• Status of Medicaid expansion
• Cancer death rate per 100,000 people
• Number of hospitals per 100,000 people

To determine scores, we sorted each state’s value in a category into quartiles — positions in a distribution such that data is distributed across four sectors. We assigned points based on quartiles for each metric: one point for placement in the first quartile, two points for second and so on. The sum of these five areas is our Care Score.

Source: ValuePenguin By Andrew Hurst

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