New Hampshire tops the nation for healthcare quality and affordability, while Alaska ranks last, according to WalletHub’s 2026 analysis of all 50 states and the District of Columbia across 44 measures of cost, access and outcomes.
The states at the top of WalletHub’s 2026 healthcare ranking share a consistent profile: costs that do not consume an outsized share of household income, physician and provider density that keeps wait times manageable, and population health outcomes that reflect years of preventive care investment.
WalletHub compared all 50 states and the District of Columbia across 44 metrics in three categories: cost, access, and outcomes. Each metric was graded on a 100-point scale, with 100 representing the best care at the most reasonable cost, and states were ranked by weighted average score.
1. New Hampshire
New Hampshire earns the top ranking with no significant weakness across cost, access or outcomes. It has the lowest average monthly health insurance premium in the country at approximately $469, the second-lowest out-of-pocket medical spending, the lowest prevalence of strokes, and the fourth-lowest rate of type-2 diabetes nationally. It ranks first in outcomes of any state.
2. Minnesota
Minnesota leads the nation in convenient care clinics per capita and posts the seventh-lowest average out-of-pocket spending. It has the eighth-best public hospital system in the country, the seventh-highest life expectancy, an extremely low maternal mortality rate and an average emergency room wait time of approximately 16 minutes. It ranks third in cost and second in access.
3. Iowa
Iowa ranks first in cost overall, with out-of-pocket spending at just 7.9% of resident income, the third-best public hospital system in the nation, and among the lowest rates of adults skipping doctor visits due to cost. It has the fifth-shortest emergency room wait time and the 10th-highest number of hospital beds per capita.
4. Rhode Island
Rhode Island ranks 13th in cost, 10th in access and ninth in outcomes. It has high physician density relative to its population, strong insurance coverage rates, one of the lowest maternal mortality rates in the country and life expectancy in the national top tier.
5. Hawaii
Hawaii ranks third in outcomes despite placing 25th in cost and 23rd in access. It consistently leads national rankings in life expectancy and has low rates of heart disease, stroke and diabetes.
6. Massachusetts
Massachusetts ranks second in outcomes and fourth in access, driven by the concentration of academic medical centers and specialists in its major metro areas. Its cost rank of 40th, the biggest weakness in its profile, reflects among the highest insurance premiums and out-of-pocket expenses in the country.
7. Maine
Maine’s strongest dimension is access, where it ranks third nationally. The state has invested significantly in rural health infrastructure, community health centers and telehealth adoption, giving it strong access scores despite a sparse population distribution.
8. Wisconsin
Wisconsin ranks sixth in access, with high physician and nurse practitioner density, strong hospital infrastructure, and one of the higher Medicare acceptance rates among physicians nationally. It ranks 13th in outcomes, with low rates of chronic disease relative to its Midwest peers and above-average life expectancy.
9. Colorado
Colorado ranks fifth in access and seventh in outcomes, with strong physician density along the Front Range and a relatively healthy population with low rates of obesity, diabetes, and cardiovascular disease. Its cost rank of 36th reflects higher-than-average insurance premiums on the individual market.
10. Nebraska
Nebraska ranks eighth in access, reflecting sustained investment in rural health clinics, community health centers and telehealth services that extend care beyond major cities. It ranks 16th in outcomes, with solid population health and above-average preventive care utilization.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.