How States Rank on ACEP Emergency Report Card

Published February 1, 2006

Access to Emergency Care

Seven states led the nation, earning “A” grades in the category–Connecticut, the District of Columbia, Maine, Massachusetts, Ohio, Pennsylvania, and Rhode Island–with no state receiving a failing grade. The category looked at the availability of emergency care resources, as well as certain kinds of state health spending, including public funding of health insurance, which makes more resources available to everyone. Nine states received D grades: Alabama, Arkansas, Arizona, Georgia, Idaho, Nevada, New Mexico, Texas, and Utah.

Quality of Care and Patient Safety

Eight states led the nation, earning “A” grades in this category–Connecticut, Delaware, District of Columbia, Georgia, Iowa, New Jersey, Pennsylvania, and West Virginia. Three states received “F” grades–Kansas, Nevada, and South Dakota–and 17 others earn[ed] “D” grades. This category looked at state support for training emergency physicians and EMS personnel as well as patient access to ambulances and 911 services.

Public Health and Injury Prevention

Five states led the nation, earning “A” grades in this category: California, Maryland, Massachusetts, Michigan, and New York. Forty-one states earned a “C” or lower in support for health and safety programs, with two states, Montana and South Dakota, earning “F” grades. This category focused on lessening the need for emergency care due to traumatic injury or preventable illnesses. It looked at indicators such as whether the state had seat belt and helmet laws, domestic violence programs, as well as state immunization rates and the number of mothers receiving prenatal care.

Medical Liability Environment

Four states led the nation, earning “A” grades in this category: California, Montana, Nevada, and Texas. Twelve states received failing grades for their medical liability environments–Arkansas, Connecticut, District of Columbia, Maryland, New Jersey, North Carolina, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia, and Wyoming–and 30 others had near failing grades. This category assessed increases in state medical liability rates as well as reform initiatives. Problems with a state’s medical liability climate can lead to physician shortages, delays in patient care, and increased patient transfers.

state Overall Grade Access to Care Quality and Patient Safety Public Health and Injury Prevention Medical Liability Environment
Alabama D+ D+ C- D+ D-
Alaska C+ B+ D+ D C
Arizona D+ D+ C C- D-
Arkansas D D+ D D F
California B C C+ A+ A+
Colorado C C+ D- D+ B-
Connecticut B A- A+ B F
Delaware C+ B- A- C+ D-
Dist. of Columbia B A+ A- C+ F
Florida C- C- B- D- D
Georgia C+ D+ A C B-
Hawaii C- C+ D+ C+ D-
Idaho D D D D- D
Illinois C B+ C D+ D-
Indiana D+ C- D C D-
Iowa C+ B- A- C D-
Kansas C- B- F D D
Kentucky C- C C C D-
Louisiana C- C- B D D
Maine B- A C+ C- D
Maryland B- B+ B+ A+ F
Massachusetts B A B A- D-
Michigan B- B+ B+ A D-
Minnesota C+ B+ C+ C D-
Mississippi C- C C+ D- D-
Missouri C+ B+ C- D+ C-
Montana C C+ D- F A-
Nebraska C- C+ C- D+ D+
Nevada C- D+ F D- A-
New Hampshire C B+ D- C- D-
New Jersey C+ C+ A+ B+ F
New Mexico D+ D+ C- D+ D-
New York C+ B- B- A+ D-
North Carolina C- C- C B+ F
North Dakota C- B- D D D
Ohio C+ A- B- D D
Oklahoma D+ C- D- C- D-
Oregon C- C+ D B+ D-
Pennsylvania B- A A- C- F
Rhode Island B- A B+ C- F
South Carolina B- C B+ D B+
South Dakota D+ C+ F F D
Tennessee C- C C D+ F
Texas C D+ D+ D A+
Utah D D+ D- D D
Vermont C B+ C C F
Virginia D+ C- D+ C F
Washington D+ C D B- D-
West Virginia C+ C+ A D D
Wisconsin C- B- D+ D+ D
Wyoming D+ C+ D- D- F
Source: ACEP