State Health Compare is a free online data tool that aggregates state-level estimates of health measures on topics ranging from the cost of care to the types of care people can access. Users can also view a number of State Health Compare measures by breakdowns like age, race/ethnicity, insurance coverage type, and more to study and compare specific populations.
SHADAC researchers update State Health Compare measures when new data is released to ensure users have the most up-to-date information possible. The National Health Interview Survey (NHIS) is a survey conducted by the Centers for Disease Control and Prevention (CDC) that gathers information about respondents’ health through face-to-face interviews. It is the nation’s oldest health survey: data collection began in 1957.
This blog summarizes updates to measures using data collected from the 2023 National Health Interview Survey (NHIS). We will review measures that were updated and highlight important changes in findings.
Trouble Paying Medical Bills
This measure shows the percentage of people who had trouble paying medical bills in the last year. These rates vary widely based on type of insurance coverage. Less than 10% of people with private coverage reported trouble paying medical bills in 2022-2023, while almost double that number (19.3%) of people who were uninsured reported the same problem.
Figure 1. Percentage of People Who Had Trouble Paying Medical Bills in the Last Year (2022-2023) by Coverage Type
Usual Source of Medical Care Other Than Emergency Department
This measure shows the percentage of people who reported having a usual source of medical care other than the emergency department in the last year.
A usual source of care is important for avoiding unnecessary and costly emergency department visits for issues that could be addressed in an outpatient setting. A usual source of care can also help with early diagnosis and treatment of issues as well as preventative care, which has been shown to help with health care costs and provide better experiences & health outcomes.
For 2022-2023, almost 90% reported having a usual source of medical care, nationally. However, as we can see using the “Rank” option on SHC, this can vary based on state with a high of 96.0% in Hawaii to a low of 79.7% in Nevada.
Had a General Doctor or Provider Visit
Reporting access to a usual source of medical care is notably distinct from regular utilization of care. This measure focuses on utilization, showing the percentage of people who reported having a general doctor or provider visit in the last year.
Looking at the “Coverage Type” breakdown using the “Bar” chart option, we can see that publicly insured respondents reported the highest percentage (89.6%) of access to a usual source of care, followed closely by those with private insurance coverage (86.7%). While the majority of the uninsured still reported having a provider visit (55.3%), their rate is much lower than those with coverage.
Figure 2. Percentage of People Who Reported Having a General Doctor or Provider Visit in the Last Year, 2022-2023, by Coverage Type
Find the measure and breakdowns by age and coverage type here.
Had a Dental Visit
Also related to utilization, this measure specifically shows the percent of people who reported a visit with a dentist. Dental health has been connected to overall health and wellbeing. People who regularly visit the dentist get preventative care, diagnoses, and treatment of issues, key steps to preventing more significant and painful dental problems.
About two thirds of respondents (68.2%) reported a dental visit in 2022-2023, and this measure is also available by age and coverage type. Check it out yourself on the measure page here.
Had a Telehealth Appointment by Video or Phone
This measure shows the proportion of respondents who reported having a medical appointment by video or phone in the past year, often called “telehealth” appointments.
Telehealth appointments have decreased from their peak of 31.6% in 2020-2021.
Figure 3. Trend, Percentage of People Who Reported Having a Medical Appointment by Video or Phone in the Past Year, 2020-2021 through 2022-2023
The decline in telehealth appointments over time also varies by age, as we can see in the graph below.
Figure 4. Percentage of People Who Reported Having a Medical Appointment by Video or Phone in the Past Year, 2020-2021 through 2022-2023, by Age Group
Telehealth rates may be decreasing because of increases in in-person visit availability after the conclusion of the COVID-19 pandemic. Continue studying this yourself with the data and information from this SHC measure.
Saw or Talked to a Mental Health Professional
This brand-new measure on State Health Compare shows users the percent of people that engaged with a mental health professional in the past year. This includes psychologists, clinical social workers, psychiatric nurses, and more. 12.7% of respondents saw or talked to a mental health professional in 2022-2023. This measure is also available by age.
You can learn more about mental health data and resources in this recent SHADAC blog.
Visited an Emergency Department
Visiting the emergency department (ED) is often costly and time consuming – and, many times, preventable with treatment available for many patients in non-emergency settings. One study estimated that “nearly 40 percent of emergency department visits are not medical emergencies.”
Unnecessary emergency department visits can increase patients’ health care costs, as well as use ED staff time and hospital resources sometimes ineffectively. This can also make it more difficult for patients with emergent conditions to be seen and treated quickly and efficiently. This is concerning because long waits in EDs are associated with higher patient mortality and worse health outcomes.
This measure shows that 17.6% of people under the age of 65 visited an emergency department in 2022-2023. This measure is also available by coverage type and shows that people with public coverage go to the emergency department more often (28.8%) than people with private coverage (15.0%).
Figure 5. Percentage of People Under Age 65 Who Visited an Emergency Department in 2022-2023 by Coverage Type
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These updated NHIS measures show that changes in the access, cost, and utilization of medical care vary over time, by state, by age and insurance coverage type, and more. Understanding this variation is crucial for creating and implementing health policies that can target populations that need increased coverage, access, utilization, and affordability.
In addition to understanding patients’ experience with the healthcare system, ongoing measurement is also essential for understanding where and how policy changes have, or have not, made an impact.
SHADAC is consistently updating each of the measures on our State Health Compare tool. To stay up-to-date, sign up for out newsletter to receive notifications about the latest products and updates. You can also follow us on LinkedIn for further updates on measures and our latest blog & briefs.