Three decades of research focused predominantly on costs and the use of services among Medicare beneficiaries has repeatedly found wide regional variations in health care experiences and health system performance.1Much less attention has been paid to variations in access to care and their associated implications for quality of care and health outcomes. Our recent Commonwealth Fund report, “Rising to the Challenge: Results from a Scorecard on Local Health System Performance,”2 shows that when we look beyond state averages, there are staggeringly wide gaps in people’s ability to gain access to care in different communities around the country. We also find a strong and persistent association between access and health care quality, including the receipt of preventive care.

Simply put, where a person lives matters — it influences the ability to obtain health care, as well as the probable quality of care that will be received — though it should not matter in an equitable health care system. This and other Scorecard findings have important implications that are relevant to national policy reforms and to newly available resources for improving access and quality of care. Learn more here.