Commonwealth Fund Scorecard on State Health System Performance, 2019

South Carolina
Ranking Highlightsa How Health Care in South Carolina
National Rank Among b
Has Changed
Rank Southeastern States
Change from Change from
2019 baseline 2019 baseline 9 9

Overall 41 of 51 -3 3 of 12 -1
Access & Affordability 41 -4 7 -2
Prevention & Treatment 42 -22 8 -5
Avoidable Use & Cost 25 0 1 0 20

Healthy Lives 40 +2 5 0 l Improved l Worsened

Health Care Disparities 47 +3 10 +1 l Little or No Change

HI

MA MN Worse than average overall performance

WA CT VT RI
IA
CO NH UT
ME WI CA NY ND OR ID MD NJ PA NE DC SD MI MT DE

IL VA AK KS AZ OH NC NM IN
WY AL TN KY
GA MO
FL LA WV
AR NV TX
Better Than Better than average overall performance SC OK MS

Top-Ranked Indicators Most Improved Indicators

Home health patients without improved mobility Home health patients without improved mobility
Nursing home residents with an antipsychotic medication Adults who went without care because of cost
Hospital 30-day readmission rate age 65 and older Uninsured adults

Bottom-Ranked Indicators Indicators That Worsened the Most

Adults who are obese Hospital 30-day mortality
Elderly patients who received a high-risk prescription drug Children without a medical and dental preventive care visit
Children who did not receive needed mental health care Children who did not receive needed mental health care

Estimated Impact of State Improvementc

Top state in the Top state in the South Carolina could expect the following gains if performance in the state improved to the
U.S. Southeast region top level at these national and regional benchmarks:

393,461 283,329 more adults and children, beyond those who already gained coverage through the ACA, would be insured

269,512 115,505 fewer adults would skip needed care because of its cost
207,360 115,200 more adults would receive age- and gender-appropriate cancer screenings
12,652 6,748 more children (ages 19–35 months) would receive all recommended vaccines
fewer premature deaths (before age 75) would occur from causes that are potentially treatable or
2,065 882
preventable with timely and appropriate care
fewer employer-insured adults and elderly Medicare beneficiaries would seek care in emergency
27,460 0
departments for nonemergent or primary-care-treatable conditions
 Table 1. State Health System Performance Indicator Data by Dimension
Best
Data State U.S. state State Data State U.S. Change over
Dimension and indicator year rate average rate ranking year rate average timeb
Access & Affordability 2019 Scorecard Baseline
Adults ages 19–64 uninsured 2017 16 12 4 42 2013 23 20 Improved
Children ages 0–18 uninsured 2017 5 5 1 26 2013 7 8 Improved
Adults age 18 and older without a usual
2017 23 23 12 27 2013 24 24 No Change
source of care
Adults age 18 and older who went without
2017 15 14 8 38 2013 19 16 Improved
care because of cost in past year
Individuals under age 65 with high out-of-
pocket medical costs relative to their 2016-17 12 10 5 40 2013-14 11 11 No Change
annual household income
Employee insurance costs as a share of
2017 7.7 6.9 4.8 40 2013 7.1 6.5 Worsened
median income
Adults age 18 and older without a dental
2016 18 16 10 43 2012 18 15 No Change
visit in past year
Prevention & Treatment 2019 Scorecard Baseline
Adults without all age- and gender-
2016 33 32 24 24 2012 32 31 No Change
appropriate cancer screenings
Adults without age-appropriate flu and
2017 62 62 54 29 2013 63 64 No Change
pneumonia vaccines
Diabetic adults without an annual
2016 -- 12 5.6 -- 2015 -- 16.9 --
hemoglobin A1c test
Elderly patients who received a high-risk
2015 15 11 5 47 -- -- -- --
prescription drug
Children without a medical home 2017 51 51 39 29 2016 49 51 No Change
Children without age-appropriate medical
and dental preventive care visits in the 2017 33 32 18 31 2016 25 32 Worsened
past year
Children who did not receive needed
2017 48 22 4 48 2016 19 18 Worsened
mental health care
Children ages 19–35 months who did not
2016 30 29 15 27 2012 28 32 No Change
receive all recommended vaccines
Hospital 30-day mortality 2014-17 14.2 13.9 12.8 29 2010-13 13.5 13.2 Worsened
Central line-associated bloodstream
infections (CLABSI), Standardized Infection 2016 0.96 0.89 0.36 39 2015 1.10 0.99 Improved
Ratio
Hospitals with lower-than-average patient
2017 37 45 9 19 -- -- -- --
experience ratings
Home health patients without improved
2017 23 25 20 10 2013 36 39 Improved
mobility
Nursing home residents with an
2017 14 15 7 12 2013 17 21 Improved
antipsychotic medication
Adults with any mental illness reporting
2014-16 21 21 16 23 2009-11 22 21 No Change
unmet need
Adults with any mental illness who did not
2014-16 60 56 42 43 2009-11 54 59 Worsened
receive treatment
 Table 1. State Health System Performance Indicator Data by Dimension (continued)
Best
Data State U.S. state State Data State U.S. Change over
Dimension and indicator year rate average rate ranking year rate average timeb
Avoidable Hospital Use & Cost 2019 Scorecard Baseline
Hospital admissions for pediatric asthma,
2015 -- 87.2 21.7 -- 2012 133.0 142.9 --
per 100,000 children ages 2–17
Potentially avoidable emergency department visits
Ages 18–64, per 1,000 employer-
2016 -- 142.2 115.9 -- 2015 -- 159.0 --
insured enrollees
Age 65 and older, per 1,000 Medicare
2015 188.8 196.9 138.3 21 2012 176.4 187.8 No Change
beneficiaries
Admissions for ambulatory care–sensitive conditions
Ages 18–64, per 1,000 employer-
2016 -- 5.3 5.3 -- 2015 -- 4.6 --
insured enrollees
Ages 65–74, per 1,000 Medicare
2017 39.5 43.9 21.7 20 2013 42.6 47.7 No Change
beneficiaries
30-day hospital readmissions
Ages 18–64, per 1,000 employer-
2016 -- 3.1 2.4 -- 2015 -- 2.9 --
insured enrollees
Age 65 and older, per 1,000 Medicare
2017 33.7 41 19.7 17 2013 36.9 43.5 No Change
beneficiaries
Skilled nursing facility patients with a
2016 20 19 11 32 2012 20 20 No Change
hospital readmission
Long-stay nursing home residents
2016 18 15 5 37 2012 20 17 No Change
hospitalized within a six-month period
Home health patients also enrolled in
2017 16 16 14 19 2013 16 16 No Change
Medicare with a hospital admission
Adults with inappropriate lower back
2016 -- 68.9 57.7 -- 2015 -- 71.1 --
imaging
Employer-sponsored insurance spending
2016 -- $4,882 $3,255 -- 2013 -- $4,697 --
per enrollee
Medicare spending per beneficiary 2017 $9,002 $9,534 $6,195 21 2013 $8,744 $9,081 No Change
Healthy Lives 2019 Scorecard Baseline
Mortality amenable to health care, deaths
2014-15 99.2 84.3 54.7 41 2010-11 102.8 85.3 No Change
per 100,000 population
Breast cancer deaths per 100,000 female
2017 20.7 19.9 15.6 31 2013 21.3 20.8 No Change
population
Colorectal cancer deaths per 100,000
2017 12.8 12.9 9.3 26 2013 15 14.6 Improved
population
Suicide deaths per 100,000 population 2017 16.3 14 6.6 26 2013 14 12.6 Worsened
Alcohol-related deaths per 100,000
2017 10.5 9.6 5.5 31 2013 7.4 8.2 Worsened
population
Drug poisoning deaths per 100,000
2017 20.5 21.7 8.1 24 2013 13 13.8 Worsened
population
Infant mortality, deaths per 1,000 live
2016 7 5.9 3.5 38 2012 7.5 6 No Change
births
Adults who report fair or poor health 2017 17 17 9 27 2013 17 16 No Change
Adults who smoke 2017 19 16 9 35 2013 22 18 Improved
Adults who are obese 2017 36 31 23 44 2013 33 29 Worsened
Children who are overweight or obese 2017 33 31 21 35 2016 33 31 No Change
Adults who have lost six or more teeth 2016 13 10 6 39 2012 15 10 Improved
 Table 2. State Disparity Indicator Data
Low- Low-
Data income State Data income Change over
Dimension and indicator year rated Disparitye ranking year rated Disparitye timef
Disparity 2019 Scorecard Baseline
Adults ages 19–64 uninsured 2017 30 -25 44 2013 39 -32 Improved
Children ages 0–18 uninsured 2017 7 -5 22 2013 9 -6 Improved
Adults age 18 and older without a usual source of
2017 23 -4 5 2013 29 -17 Improved
care
Adults age 18 and older who went without care
2017 25 -18 36 2013 32 -26 Improved
because of cost in past year
Individuals under age 65 with high out-of-pocket
2016- 2013-
medical costs relative to their annual household 28 -26 29 28 -26 No Change
17 14
income
Adults age 18 and older without a dental visit in
2016 27 -17 50 2012 28 -18 Improved
past year
Adults without all age- and gender-appropriate
2016 38 -15 41 2012 39 -17 Improved
cancer screenings
Adults without age-appropriate flu and
2017 67 -11 45 2013 69 -15 Improved
pneumonia vaccines
Children without a medical home 2017 58 -18 11 2016 57 -22 No Change
Children without age-appropriate medical and
2017 37 -15 29 2016 24 -2 Worsened
dental preventive care visits in the past year
Children ages 19–35 months who did not receive
2016 34 -9 19 2012 35 -22 Improved
all recommended vaccines
Hospital admissions for pediatric asthma, per
2015 -- -- -- 2012 194.5 -143.9 --
100,000 children ages 2–17
Potentially avoidable emergency department
visits, Medicare beneficiaries age 65 and older, per 2014 440.1 -273.7 49 2012 384.7 -233.3 Worsened
1,000 beneficiaries
Hospital admissions for ambulatory care–sensitive
conditions, Medicare beneficiaries age 65 and 2015 101.2 -61.7 32 2012 105.4 -57.2 No Change
older, per 1,000 beneficiaries
30-day hospital readmissions among, Medicare
beneficiaries age 65 and older, per 1,000 2015 69.3 -42.4 47 2012 80.7 -48.2 Improved
beneficiaries
Adults who report fair or poor health 2017 30 -24 33 2013 28 -21 Worsened
Adults who smoke 2017 27 -15 22 2013 28 -16 Improved
Adults who are obese 2017 45 -10 23 2013 41 -10 No Change
Adults who have lost six or more teeth 2016 21 -17 37 2012 22 -15 No Change

Notes
(a) The 2019 Scorecard rankings generally reflect 2017 data. The 2019 Scorecard added or revised several performance measures since the May 2018 Scorecard report;
rankings are not comparable between reports. Rank change from the baseline period represents states' rank difference from the baseline data year (generally 2012 or 2013).
Positive values represent an improvement in rank; negative values are a worsening in rank.
(b) Trend data available for 45 of 47 total Scorecard indicators. Improved/worsened denotes a change of at least one half (0.5) standard deviation larger than the indicator’s
distribution among all states over the two time points. No change denotes no change in rate or a change of less than one-half standard deviation.
(c) Estimated impact if this state’s performance improved to the rate of two benchmark levels — a national benchmark set at the level of the best-performing state and a
regional benchmark set at the level of the top-performing state in region (www.bea.gov: Great Lakes, Mid-Atlantic, New England, Plains, Rocky Mountains, Southeast,
Southwest, West). Benchmark states have an estimated impact of zero (0). Equivalent estimated impact based on national and regional benchmarks indicate that the best
observed rate in the region was equal to the best observed rate nationally.
(d) Rates are for states' low income population, generally those whose household income is under 200% FPL.
(e) Disparity is the difference between the states' low-income and higher-income (400%+ FPL) populations.
(f) Improvement indicates that the low-income rate improved and the disparity between low- and higher-income populations narrowed; worsening indicates the low-income
rate worsened and the disparity between low- and higher-income populations widened.