Category Grades
36D+ 42D
Access to Emergency Care:
33D- 34F
Quality/Patient Safety:
41D 49F
Medical Liability:
17C 26C
Public Health/ Injury Prevention:
51F 45F
Disaster Preparedness:
3A 3B+

Louisiana continues to support one of the best Disaster Preparedness systems in the nation, with robust training and well-developed plans and policies in place. However, the state has faltered in its Quality and Patient Safety Environment, which lacks similar statewide policies and procedures for providing superior care.

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Louisiana's Disaster Preparedness is third best in the nation. The state has strong protocols and plans to help ensure the safety of medically fragile patients and a demonstrated commitment to including stakeholders' input in the state's planning. Louisiana has robust systems for preparing emergency workers, with just-in-time training systems available statewide and a well-above-average rate of nurses who have received disaster training (42.2%). The state's medical workforce is engaged, with the fifth highest per capita rate of physicians registered in the Emergency System for Advance Registration of Volunteer Health Professionals (146.7 per 1 million people). Louisiana also has secured additional liability protections for health care workers during a disaster by passing Uniform Emergency Volunteer Health Practitioners Act model legislation.

Louisiana's Medical Liability Environment is moderate and boasts the lowest average malpractice award payments in the nation at $75,882óa 75% decrease since the previous Report Cardóalthough the number of award payments has increased significantly (3.6 per 1,000 physicians), as has the number of National Practitioner Databank Reports (55.6 per 1,000 physicians), which indicates the high number of cases that are reviewed. Louisiana has enacted several reforms that protect its health care workforce, including mandatory pretrial screening panels whose findings are admissible as evidence, required periodic payments of awards, and a medical liability cap on damages.


Adequate Access to Emergency Care continues to be a major concern in Louisiana, which has among the highest rates of adults and children without health insurance (23.9 and 11.6%, respectively) and a desperate need for primary care and mental health care providers. Access to trauma centers is particularly problematic as well, with the fewest Level I or II trauma centers per capita (0.4 per 1 million people) and a low proportion of its population living within 60 minutes of a Level I or II trauma center (59.1%).

While Louisiana's provisions for Quality and Patient Safety are among the weakest in the nation, initiatives are underway to address some of the key areas of concern. For example, while the state does not fund quality improvement efforts within the emergency medical services (EMS) system, the Bureau of Health Standards requires mandatory reporting of quality assurance for ambulance licensure and renewals. Additionally, while the state does not currently have ST-elevation myocardial infarction (STEMI) or stroke systems of care, the Louisiana Emergency Response Network has been working with its provider partners throughout the state to make substantial progress towards developing those systems.

Louisiana continues to face many challenges in the area of Public Health and Injury Prevention. Traffic safety is a pressing concern: Louisiana has the second highest rate of pedestrian deaths in the nation (12.0 per 100,000 pedestrians) as well as high rates of motor vehicle occupant deaths (13.7 per 100,000 people). Louisiana's people also face dire health risk factors, with high proportions of adults who smoke (25.7%) and high rates of obesity among adults and children (33.4 and 21.1%, respectively). The state has among the 10 highest infant mortality rates (7.6 deaths per 1,000 live births) and infant mortality disparity ratios (3.3), which means that the mortality rate among non-Hispanic Black infants is more than three times higher than the racial and ethnic group with the lowest rate.


Louisiana should work to improve its Quality and Patient Safety Environment by investing in improvements to the EMS system and funding a state EMS medical director. The state should continue efforts to fully implement systems of care for stroke and STEMI patients.

Louisiana must make a concentrated effort to address the poor health risk factors affecting the health and well-being of all through outreach and education aimed at reducing smoking and obesity, as well as measures to improve access to primary and preventive care. A public health commitment to improving traffic safety for motorists, bicyclists, and pedestrians alike is also needed.

The state's poor showing in Access to Emergency Care could be improved by a focus on ensuring that Louisiana's denizens have access to adequate health insurance. At the same time, the state must invest in provider recruitment and retention to fill the gaps in access to primary care.

Access to Emergency Care

Title 2009
Report Card
Report Card
Board-certified emergency physicians per 100,000 pop 6.9 8.6
Emergency physicians per 100,000 pop 12.5 13.9
Neurosurgeons per 100,000 pop 2.5 2.4
Orthopedists and hand surgeon specialists per 100,000 pop 9.8 10.0
Plastic surgeons per 100,000 pop 2.0 2.1
ENT specialists per 100,000 pop 5.0 5.4
Registered nurses per 100,000 pop 921.2 892.7
Percent of children able to see provider 94.3
Level I or II trauma centers per 1M pop 0.2 0.4
Percent of population within 60 minutes of Level I or II trauma center 11.3 59.1
Accredited chest pain centers per 1M pop 2.1 2.2
Percent of population with an unmet need for substance abuse treatment 8.5 8.7
Pediatric specialty centers per 1M pop 5.2 6.3
Medicaid fee levels for office visits as a percent of the national average 73.8 86.8
Percent change in Medicaid fees for office visits (2004-05 to 2007/2007 to 2012) -19 44.6
Percent of adults with no health insurance 23.9 23.9
Percent of adults underinsured 8.6
Percent of children with no health insurance 15.9 11.6
Percent of children underinsured 15.3
Percent of adults with Medicaid 9.6 10.9
Hospital closures in 2006/2011 1 0
Staffed inpatient beds per 100,000 pop 468.7 414.2
Hospital occupancy rate per 100 staffed beds 64.1 59.6
Psychiatric care beds per 100,000 pop 23.8 21.3
Median time from ED arrival to ED departure for admitted ED patients 266
State collects data on diversion YES NO

Disaster Preparedness

Title 2009
Report Card
Report Card
Per capita federal disaster preparedness funds $9.82 $5.24
State budget line item health care surge NO
ESF-8 plan is shared with all EMS and essential hospital personnel YES YES
Emergency physician input into the state planning process YES, YES YES
Public health and emergency physician input during an ESF-8 response YES
Drills, exercises conducted involving hospital personnel, equipment, or facilities per hospital
Accredited by the Emergency Management Accreditation Program (EMAP) YES, ACCREDITED NO
Special needs patients included in medical response plan YES YES
Patients dependent on medication for chronic conditions in medical response plan YES YES
Medical response plan for supplying dialysis YES YES
Mental health patients included in medical response plan YES
Medical response plan for supplying psychotropic medications YES
Mutual aid agreements in place with behavioral health providers STATE LEVEL
State requires long-term care and nursing home facilities to have a written disaster plan YES
State able to report number of exercises involving long-term care facilities or nursing YES
Just-in-time training systems in place STATEWIDE STATEWIDE
Statewide medical communication system with one layer of redundancy YES YES
Statewide patient tracking system YES YES
Statewide real-time or near real-time syndromic surveillance system YES YES
Real-time surveillance system in place for common ED presentations YES YES, STATEWIDE
Bed surge capacity per 1M pop NR 2,066.5
ICU beds per 1M pop 348.1 354.4
Burn unit beds per 1M pop 6.5 9.1
Verified burn centers per 1M pop 0.0 0.0
Physicians registered in ESAR-VHP per 1M pop 106.0 146.7
Nurses registered in ESAR-VHP per 1M pop 319.1 194.9
Behavioral health professionals registered in ESAR-VHP per 1M pop 19.3
Strike teams or medical assistance teams YES YES
Disaster training required for essential hospital/EMS personnel YES, NO NO
Percent of RNs that received emergency training 40.2 42.2

Medical Liability Environment

Title 2009
Report Card
Report Card
Lawyers per 10,000 pop 17.0 15.9
Lawyers per physician 0.6 0.6
Lawyers per emergency physician 13.4 11.4
ATRA judicial hellholes (2009 range 0 to -7/2014 range 2 to -6) 0 -1
Malpractice award payments per 100,000 pop 1.5 3.6
Average malpractice award payments $208,283 $75,882
National Practitioner Databank reports per 1,000 physicians 40.6 55.6
Apology laws: Apology is inadmissible as evidence in a court of law YES
State has implemented a patient compensation fund YES YES
Number of insurers writing medical liability policies per 1,000 physicians 5.2 5.9
Average medical liability insurance premiums for primary care physicians $19,004 $17,358
Average medical liability insurance premiums for specialists $73,176 $65,738
Presence of pretrial screening panels MANDATORY MANDATORY
Pretrial screening panel's findings admissible as evidence YES YES
Periodic payments are: required, granted upon request, at court's discretion REQUIRED BY STATE REQUIRED
Medical liability cap on non-economic damages $350,001-500,000 $350,001-500,000
Additional liability protection for EMTALA-mandated emergency care NO NO
Joint and several liability abolished YES YES
Collateral Source Rule/Provides for Awards to be Offset NO
State provides for case certification NO NO
Expert witness required to be of the same specialty as the defendant NO NO
Expert witness must be licensed to practice medicine in the state NO NO

Public Health & Injury Prevention

Title 2009
Report Card
Report Card
Bicyclist fatalities per 100,000 cyclists 9.8
Pedestrian fatalities per 100,000 pedestrians 12.0
Percent of traffic fatalities alcohol-related 48.0 38
Percent of front occupants using restraints 75.2 77.7
Child safety seat/seat belt legislation - score out of a possible 10 points 5 6
Helmet use required for all motorcylce riders YES YES
Distracted driving legislation score - out of a possible 4 points 2
Graduated drivers' licenses legislation score -out of a possible 5 points 2
Percentage of children aged 19-35 months who are immunized 72.3 79.5
Percentage of adults aged 65+ who rec’d an influenza vaccine in the last 12 mos 64.4 70.2
Percentage of adults aged 65+ who ever rec’d pneumococcal vaccine 66.4 69.1
Fatal occupational injuries per 1M workers 62.3 54.0
Homicides and suicides (non-motor vehicle)(per 100,000) 24.3 24.0
Unintentional fall-related fatal injuries (per 100,000) 4.0 4.5
Fire/burn related fatal injuries (per 100,000) 2.3 1.6
Rate of unintentional firearm-related fatal injuries (per 100,000) 0.8 0.9
Rate of unintentional poisoning-related deaths (per 100,000) 11.4
Total injury prevention funds per 1,000 persons $232.93 $80.87
Dedicated child injury prevention funding NO
Dedicate elderly injury prevention funding NO
Dedicated occupational injury prevention funding NO
Anti-smoking legislation score - score out of a possible 3 points 2
Infant mortality rate per 1,000 live births 10.1 7.6
Percentage of adults who binge drink 13.3 16.1
Percentage of adults who currently smoke 23.4 25.7
Percentage of adult population who are obese (BMI > 30.0) 27.1 33.4
Percentage of children who are obese 21.1
Cardiovascular disease disparity ratio 1.6
HIV diagnosis disparity ratio 7.0
Infant mortality disparity ratio 3.3

Quality & Patient Safety

Title 2009
Report Card
Report Card
Funding for quality improvement within the EMS system NO NO
Funded state EMS medical director YES NO
Emergency medicine residents per 1M pop 23.5 25.9
Adverse event reporting required YES NO
% of counties with Enhanced 911 capability 95.2 100.0
State has a uniform system for providing pre-arrival instructions NO NO
State uses CDC guidelines for state field triage protocols YES (2011)
State has or is working on a stroke system of care YES NO
State has triage and destination policy in place for stroke patients NO
State has or is working on a PCI network or a STEMI system of care YES NO
State has triage and destination policy in place for STEMI patients NO
State maintains statewide trauma registry NO YES
State has triage and destination policy in place for trauma patients YES
Prescription drug monitoring program score (range 0-4) 3
% of hospitals with computerized practitioner order entry 10.7 63.6
% of hospitals with electronic medical records 35.1 87.0
% of patients with AMI given PCI within 90 minutes of arrival 34 90
Median time to transfer to another facility for acute coronary intervention 102
% of patients with AMI who received aspirin within 24 hours 99
% of hospitals collecting data on race/ethnicity and primary language 30.1
% of hospitals with or planning to develop a diversity strategy or plan 22.6

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