"All of those who contribute to Iowa's child-directed health systems should be gratified by our state's designation as a national leader through The Commonwealth Fund report," says Christopher Atchison, director of the University Hygienic Laboratory (UHL). "Because we provide testing for all babies shortly after their birth, the Hygienic Laboratory is one of the first state agencies to positively impact the lives of Iowa's youngest citizens."

As the designated laboratory for Iowa's Neonatal Metabolic Screening Program, the UHL screens approximately 40,000 Iowa newborns each year. Babies born in every corner of the state are tested shortly after birth for conditions that, if left unidentified, could cause serious developmental delays, coma or death.

"Regardless of where a child is born, we rapidly conduct screening for up to 40 different conditions," Atchison says. "We have provided this vital testing for more than two decades, and last year, the Hygienic Laboratory celebrated its one-millionth screening."

The report by The Commonwealth Fund evaluated all 50 states and the District of Columbia in five primary health care areas: access, quality, costs, equity and potential to lead healthy lives. Iowa scored number one in the report's overall ranking followed by Vermont, Maine, Massachusetts and New Hampshire. Of these top five states, Iowa earned the best score for per-capita health care costs and for the cost of insurance premiums. The Hawkeye State also was ranked second in the nation for both access to health insurance and quality of services provided.

The Iowa Health Care Reform bill passed on April 26 as House File 2539 was not included in the report's data. It will provide comprehensive coverage through affordable insurance for all Iowa children within the next three years. An estimated 53,000 Iowa kids who are currently uninsured will be the first to benefit from the new law.

"This landmark legislation demonstrates Iowa's commitment to inclusive services for all children," Atchison says. "It also addresses the importance of establishing a 'medical home,' through which these services are coordinated. Because each child is unique and many have a myriad of needs, the integrated concept of a medical home can improve health care quality by increasing access to services."

A "medical home" is established through a primary care provider who delivers accessible, family-centered health care using a team approach. This concept is addressed in the reform bill and is one goal of Iowa's Off to a Good Start Coalition, co-sponsored by the Institute for Public Health Practice at the UI College of Public Health, the Child and Family Policy Center and the Iowa Prevention of Disabilities Policy Council. Coalition efforts include establishing a medical home for medical and dental services, preventative health services and prenatal care.

The Commonwealth Fund report states that Iowa has created "children's health care systems that are accessible, equitable and deliver high-quality care, all while controlling levels of spending and family health insurance premiums. Over the last decade, both states (Iowa and Vermont) adopted policies to expand children's access to care and improve their quality of care. In particular, Iowa and Vermont expanded SCHIP (State Children's Health Insurance Program) and mandated that all child health plans and local and regional children's health systems publicly report data on the quality of care. This analysis indicates that such policies make a difference."

The complete report by The Commonwealth Fund is available online at www.commonwealthfund.org.