Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2011 January 5, 2014 | In this National Scorecard on U.S. Health System Performance, the U.S. health care system achieved a score of 64 out of 100. Despite pockets of improvement, the United States as a whole failed to improve when compared with the top 10 percent of U.S. states, regions, health plans, or health care providers, or the top-performing countries. The scorecard measures the health system across 42 key indicators of health care quality, access, efficiency, equity, and healthy lives. View the Resource “Why not the best: results from the national scorecard on U.S. health system performance.” The Commonwealth Fund, 2011. New York, NY: Commonwealth Fund, Commission on a High Performance Health System, 2011.