Virginia is one of the top-performing states for healthcare experience in the country, but even the best states are earning what amounts to a barely-passing grade, according to a new national survey released last month by West Health and Gallup.
The assessment, which surveyed more than 20,000 people nationwide, is the first to evaluate all 50 states on cost, access and quality of care.
No state in the country scored higher than a C+ on overall health care performance.
Virginia ranked fifth overall, helped along by strong hospital systems, Medicaid expansion and long-standing investments in primary care.
Tim Lash is the chief executive officer and lead researcher of West Health, a network of nonprofits focused on affordable healthcare. He said Virginia’s high ranking does not mean residents are getting the care they need.
“One in five Virginians are saying they can’t afford the treatment that’s recommended,” Lash said. “That’s unacceptable, and it tells us that we need to work together to have reform systemically across healthcare that can address what is an unbearable situation for families.”
Virginia earned a D+ in affordability, one of the lowest of its scores and a key reason that Lash said most top-ranked states are struggling.
Lash said the low affordability grade reflects the high cost of care in many of Virginia’s urban markets, where hospital prices and insurance premiums trend above the national average.
As federal Affordable Care Act tax credits expire and Virginia continues to face a deepening nursing shortage, pressures on the health-care workforce and rising premiums are pushing costs even higher for families.
“So it's not surprising to me that people rank their health care as a barely-passing grade, because if one in five are saying I can't get the care that I need, it would be like doing a survey and saying, ‘What is the best cancer to have,’ right?” Lash said.
Rising treatment costs nationwide also continue to outpace wages and household budgets, he noted.
Julian Walker, vice president of communications for the Virginia Hospital & Healthcare Association, said the affordability concerns reflected in the survey align with trends across the state.
Premiums and out-of-pocket costs, he said, are rising much faster than what insurers actually spend on care.
Data show private insurance premiums in Virginia grew 20.2% for individuals and 22.1% for families, compared with just 1.2% growth in total personal health care spending from 2019 to 2023.
“This is something the public perceives, with polling of Virginia voters showing they think insurers, pharmaceuticals, and government actions bear the most responsibility for rising health care costs,” Walker said in a statement sent to WHRO.
Despite those pressures, Walker said Virginia hospitals continue to rank among the safest in the country, contribute more than $62 billion to the state economy and help fund Medicaid expansion, which has expanded care for thousands of low-income adults.
Lash hopes the survey can act as a roadmap for states looking to improve their health systems.
“As we think about reforming, we need to do it with families and communities in the states – not to them,” Lash said.
