Survey: Maryland scores #6 in healthcare during the pandemic

A nurse treats a patient with coronavirus in the intensive care unit of a hospital in Leonardtown on May 1, 2020. Photo by Win McNamee / Getty Images.

This story is reprinted from state borderan initiative of the Pew Charitable Trusts.

Hawaii and Maine health systems have fared better than all states during the COVID-19 pandemic, according to new rankings that reviewed factors such as vaccination rates, capacity in hospitals and intensive care units, and death rates.

Alabama was at the bottom of the list of results, followed by Oklahoma, Kentucky, Mississippi and Georgia.

Maryland scored at No. 6.

The Rankings released last weekCompiled by the Commonwealth Trust, a private institution that works to advance health equity and raise the quality, efficiency and accessibility of health care. Each year, the Commonwealth uses dozens of procedures to produce a classification of government healthcare systems. This year, it added categories on how government health care systems are performing during COVID-19 from February 2020 to the end of March 2022. Vermont, Washington and Oregon chose the top five.

In general, states judged to have stronger health systems overall also rank well in COVID-19 performance. The opposite was true for those who scored poorly in the overall health care ranking.

The speed with which states got into the fire after vaccines first became available at the end of 2020 was one of the measures the Commonwealth used in assessing the country’s response to COVID-19.

Vermont moved the fastest, followed by Massachusetts, Connecticut and Maine. They were able to fully vaccinate (meaning, usually, two doses) 70% of the population aged 12 years or older within 200 days from the time the vaccines became available.

By contrast, 21 states had not yet reached 70% by the end of March 2022. Alabama, Mississippi, and Wyoming had failed to even reach 60%.

Although the US Centers for Disease Control and Prevention recommended boosters, less than 40% of US adults had had them by the end of March, with rates varying widely across states.

More than half of adults received boosters in Maine, Rhode Island, and Vermont. By contrast, even a quarter of adults in Alabama, Mississippi, and North Carolina did not receive a booster injection.

Another measure that Commonwealth analysts have looked at has been how stressed hospital systems have become during the pandemic. The report noted that between August 2020 and March 2022, the country saw 4.6 million hospitalizations linked to COVID-19. To determine how stressed health systems are, analysts measured the number of days during that period that at least 80% of ICU beds were occupied in each state.

They found that 16 states and the District of Columbia have operated intensive care units at 80% capacity or more for at least 150 days. Texas and Alabama have been at or above this ratio for 566 and 517 days, respectively. Georgia, Mississippi, New Mexico, Oklahoma, and Rhode Island each exceeded 300 days at 80% or more.

One other metric the Commonwealth used in its rankings was the number of “excess” deaths that each state experienced during the pandemic. The analysis shows that excess deaths mean above-average deaths, some as a result of COVID-19, but others as a result of disruption to health care access due to the pandemic.

In general, states with stronger public health systems had fewer excess deaths than states with weaker systems.

The number of excess deaths ranged from 110 per 100,000 people in Hawaii to as high as 596 per 100,000 in Mississippi.

The analysis found, nationwide, that premature deaths from treatable diseases such as heart disease and diabetes rose between 2019 and 2020 from 83.8 to 89.8 deaths per 100,000 residents. The increases were most pronounced in the Midwest and South.

The good news in the report was that the rate of people with health care insurance remained fairly stable across states during the pandemic, although it declined slightly in 2021.

Reasons: Fewer people lost employer-sponsored health insurance than expected, safety net provisions in the Affordable Care Act helped those who lost their insurance, actions taken by Congress early in the pandemic kept Medicaid-enrolled people in, and rising benefits became Available during the pandemic to help people pay for private health insurance plans.

Some of these provisions will expire when the national public health emergency is eventually lifted, potentially causing a sharp decline in the numbers of people with health insurance.

Performance of the government healthcare system on COVID-19

1. Hawaii 26. Ohio
2. Min 27. Kansas
3. Vermont 28. Michigan
4. Washington 29. Rhode Island
5. Oregon 30. South Dakota
6. Maryland 31. Tennessee
7. Utah 32. North Carolina
8. Massachusetts 33. Indiana
9. Minnesota 34- Montana
10. Connecticut 35- Nevada
11. Virginia 36. Wyoming
12. Illinois 37. New Mexico
13. New Hampshire 38. Arizona
14. Alaska 39. Missouri
15. Nebraska 40. Louisiana
16. New York 41. North Dakota
17. Colorado 42. Arkansas
18. New Jersey 43. Texas
19. California 44. West Virginia
20. Wisconsin 45. South Carolina
21. Iowa 46- Georgia
22. Idaho 47. Mississippi
23. Delaware 48. Kentucky
24. Florida 49- Oklahoma
25- Pennsylvania 50. Alabama

Source: Commonwealth Fund