Massachusetts ranks among the top states where Medicare serves its residents the best, offering some of the best access to primary care providers, yet its beneficiaries experience the second-to-highest preventable hospital admissions rates in the nation.
Massachusetts ranks among the top states where Medicare serves its residents the best, offering some of the best access to primary care providers, yet its beneficiaries experience the second-to-highest preventable hospital admissions rates in the nation.
The Bay State was the 10th highest-performing state in 2025 Medicare efficacy, according to a Medicare score card report published Thursday by The Commonwealth Fund, a New York-based healthcare research and policy organization.
The Commonwealth Fund ranked states based on 31 performance indicators through data collected from 2023 through 2025. Indicators were grouped into four categories: access to care, quality of care, cost and affordability, and population health.
Just over one in five Massachusetts residents are enrolled in Medicare, according to the study. At 20.6%, the state enrolls just slightly more than the nation’s average of 19.8%
Massachusetts was the 11th-best performing state when it came to the percentage of Medicare beneficiaries 65 years and older with a usual care provider. Another 2.6% of these beneficiaries reported not having a personal healthcare provider, compared to the nation’s average of 4.0%.
For adults aged 18-64 who the state’s Medicare beneficiaries, 12.8% did not have a primary care provider. While considerably higher than the rate for seniors, the state’s percentage was the third-best performing of all states, as the nation’s average sits at 20.9%.
Still, Massachusetts is experiencing a
primary care shortage. In August, Boston-based Mass General Brigham and CVS
proposed a clinical affiliation in an effort to address the deficiency.
While the state’s beneficiaries experienced some of the best access to primary care, which is one of the best deterrents of unnecessary emergency room visits, the commonwealth still experienced the second-highest rate of potentially preventable hospital admissions in the country.
The state experienced 33 preventable hospital admissions for ambulatory care-sensitive conditions per 1,000 Medicare beneficiaries. The only state with more preventable hospital admissions was West Virginia, which experienced 34.7 preventable ambulatory care-sensitive admissions per 1,000 beneficiaries.
The country’s average was 26.5 per 1,000.
These visits can happen due to acute exacerbations of chronic conditions, which often occurs when underlying diseases are detected late or are poorly managed, according to The Commonwealth Fund.
Furthermore, high rates of preventable hospitalizations, like those in Massachusetts, often indicate practice patterns and local health system capacities, the report said.
In line with this reasoning, a study published in February by the Boston-based Massachusetts Health Policy Commission reported
ER wait times are on the rise throughout the state, with 39% of behavioral health-related emergency department visits lasting more than 12 hours.
In tandem with longer wait times, incidence of
abuse against ER workers has dramatically increased in the past five years, with a worker experiencing physical assaults, verbal abuse, or threats every 36 minutes.
Mica Kanner-Mascolo is a staff writer at Worcester Business Journal, who primarily covers the healthcare and diversity, equity, and inclusion industries.
