An article titled “5 Best States to Retire In” by Roger Yu in Sunday’s USA Today started off like this: “Go north, retirees. Despite its harsh winter, New Hampshire is the best place to retire, according to personal finance site Bankrate.com. Colorado, Maine, Iowa and Minnesota round out its top five retirement destinations.” Numerous other media outlets picked up the story.
Yu cited information from a March 31st article by Claes Bell, a Bankrate.com analyst, which referenced a new Bankrate.com survey. The desirability of states as retirement destinations was determined in this survey by evaluating financial and lifestyle categories important to retirees. Cost of living was most important to those surveyed followed in rank order by health care quality, crime, cultural vitality, weather, taxes, senior citizens’ well-being and the prevalence of other seniors citizens.
Not surprisingly, Maine ranked towards the bottom on cost of living (38), weather (44) and taxes (35). But there was one ranking that was stunning. According to Bell’s article, Maine ranked first in health care quality. To say this is surprising is an understatement. Many areas in Maine have shortages of primary care doctors. For some specialties, such as dermatology and rheumatology that are important to older Mainers, the shortages are acute with available appointments in some locations as much as six months to a year away. So, how could Maine be number one in healthcare?
When asked about the sources used to determine healthcare ranking in the survey, Bell responded, “The Agency for Health Care Research and Quality (AHRQ) publishes scores for each state based on studies they do of efficacy, access and overall outcomes for patients, so that’s one source I use. The other is a metric from the United Health Foundation that’s also based on data on patient experiences and outcomes, except it’s focused on seniors in particular.”
A review of AHRQ’s data revealed that Maine is ranked number one in “Quality Measures in Achievable Benchmarks” a subcategory of National Healthcare Quality and Disparities Reports. But this is a poor measure of healthcare availability and quality issues of interest to retiring seniors.
Maine’s score of 96 is a rating of measures that achieved the benchmark or better. Those measures include metrics such as “adolescent females ages 16-17 who received 1 or more doses of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) since the age of ten years” and “adults who had a doctor´s office or clinic visit in the last 12 months who sometimes or never got advice to quit smoking from provider, Medicare managed care.” Those are hardly criteria retirees would use to evaluate healthcare quality and availability.
Before the Bankrate.com article was published and picked up by other media outlets, rankings of Maine’s desirability as a year round retirement location were far less flattering and perhaps deservedly so. A March 29th article on the U.S. News & World Report website by Mark Silva, assistant managing editor, compares the Bankrate.com rating with its own “Best States” rating. Maine ranks 18th in the Best States rating and third on Bankrate.com.
Gordon Smith, executive vice president of the Maine Medical Association, agrees there are counties, primarily in rural Maine, with doctor shortages. He also says Maine “has done more than other states” to improve the quality of patient care. Much of the information available about the increasing healthcare needs of the state including care for a burgeoning group of baby boomer retirees is anecdotal, according to Smith “There is no state planning going on. There used to be studies and a state health plan. But that was tossed aside in 2010. As a result, much of what may or may not happen is pure speculation,” he said.
Hospitals across the state are actively recruiting doctors. But factors, like Maine’s recently passed 3 percent surtax on Maine residents earning more than $200,000 a year, deter some physicians from accepting employment offers. Will an influx of retirees thinking that Maine’s healthcare system is the best in the nation additionally strain resources? Time will tell. Because of its demographics, Maine is already experiencing the effects of the Age Wave in a number of areas. Other states would do well to take notice of what does and does not work here.