Category Grades
34C- 26C-
Access to Emergency Care:
27C- 16C-
Quality/Patient Safety:
24C 38D+
Medical Liability:
19C 22C
Public Health/ Injury Prevention:
49F 50F
Disaster Preparedness:
27C+ 19C

Mississippi has solid response plans in place for Disaster Preparedness, a good supply of specialty medical care facilities, and reforms in place to discourage unfounded medical malpractice litigation. However, the state suffers from several challenging issues in Public Health and Injury Prevention and a subpar Quality and Patient Safety Environment.

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Mississippi supports a relatively strong Medical Liability Environment. The state provides for case certification by an expert witness, which can help identify lawsuits without merit, and it has abolished joint and several liability. Mississippi has capped medical liability awards for noneconomic damages at a moderate rate and the average malpractice award payments are the 6th lowest in the nation ($153,415). These reforms have helped lower medical liability insurance premiums: The premiums for primary care physicians are just $7,062, more than $6,000 below the national average; and $36,223 for specialists, more than $21,000 below the national average.

While Mississippi faces a critical health care workforce shortage, the state ranks well in Access to Emergency Care overall due in large part to high levels of hospital capacity. Its population enjoys high per capita rates of pediatric specialty centers and emergency departments (ED), and it has the highest rate of psychiatric care beds in the nation (52.7 per 100,000 people). In conjunction with a low hospital occupancy rate and the third highest rate of staffed inpatient beds, the state has one of the lowest ED wait times in the country (217 minutes from ED arrival to ED departure).

In Disaster Preparedness, Mississippi has numerous policies in place to respond uniformly and effectively to a disaster. For instance, the state has an Emergency Support Function 8 (ESF-8) plan that is shared with all emergency medical services and essential hospital personnel, and it incorporates public health and emergency physician input during an ESF-8 response. The state also has a medical communication system with one layer of redundancy, a statewide patient-tracking system, and a statewide syndromic surveillance system.


Mississippi has failed to improve in Public Health and Injury Prevention, with high rates of fatal injury and poor marks in health risk factors. It has the highest rates of adult and child obesity in the nation (34.9% and 21.7%, respectively) as well as high adult smoking rates (26.0%). Mississippi's infant mortality rate is 9.7 deaths per 1,000 live births, compared with the national average of 6.2. It has some of the highest rates of homicides and suicides, fire- and burn-related deaths, and accidental firearm deaths in the country. Most critically, traffic safety in Mississippi is a major concern: The state has the second highest rate of motor vehicle occupant deaths (19.8 per 100,000 people), the highest rate of bicyclist deaths (14.1 per 100,000 cyclists), and one of the highest rates of pedestrian deaths (10.4 per 100,000 pedestrians).

Although Mississippi has many policies and procedures in place to enhance the Quality and Patient Safety Environment, it has slipped in these rankings, largely because its hospitals have not kept pace with most states regarding adoption of technological advances. Only 59.8% of the state's hospitals have computerized practitioner order entry, compared with 77.1% nationally; and only 79.4% have adopted electronic medical records, far less than the national average of 92.0%. Fewer than half the state's hospitals are collecting data on race and ethnicity and primary language.


Mississippi has several troubling trends in Public Health and Injury Prevention. A focus on lowering the state's adult and child obesity rates is critical. Mississippi's high rate of smoking should be addressed by enhancing current laws to ban all smoking in bars, restaurants, and workplaces. Finally, Mississippi's roads are dangerous, with very high numbers of deaths for drivers and passengers, cyclists, and pedestrians. Enhancing and enforcing existing traffic safety laws, as well as a concerted educational and outreach effort is needed to help make roadways safer for all road users.

Mississippi has a severe workforce shortage and must work to recruit and retain emergency physicians, orthopedists and hand surgeons, and primary care providers in particular. While the state's Medicaid fee levels for office visits are 122.1% of the national average and have trended positively since 2007, the state must do more to attract providers to fill this critical gap.

Finally, Mississippi's Disaster Preparedness grade was hampered by a lack of infrastructure for responding to the diverse needs of patients during a natural disaster or mass casualty event. The state has no physicians, nurses, or behavioral health providers registered in the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP), and it has no burn unit beds. Enhancing volunteer health provider capacity would help the state respond quickly and effectively to disasters.

Access to Emergency Care

Title 2009
Report Card
Report Card
Board-certified emergency physicians per 100,000 pop 4.8 6
Emergency physicians per 100,000 pop 7.9 9.1
Neurosurgeons per 100,000 pop 2.1 1.9
Orthopedists and hand surgeon specialists per 100,000 pop 6.5 7.2
Plastic surgeons per 100,000 pop 1.6 1.8
ENT specialists per 100,000 pop 3.6 3.7
Registered nurses per 100,000 pop 874.4 995.5
Percent of children able to see provider 94.5
Level I or II trauma centers per 1M pop 1.7 2.7
Percent of population within 60 minutes of Level I or II trauma center 56.6 78.1
Accredited chest pain centers per 1M pop 0.7 2.7
Percent of population with an unmet need for substance abuse treatment 7.3 6.7
Pediatric specialty centers per 1M pop 9.3 7
Medicaid fee levels for office visits as a percent of the national average 116.2 122.1
Percent change in Medicaid fees for office visits (2004-05 to 2007/2007 to 2012) 1 29.2
Percent of adults with no health insurance 21.4 18.7
Percent of adults underinsured 9.9
Percent of children with no health insurance 18.9 9
Percent of children underinsured 15.2
Percent of adults with Medicaid 11.8 11.1
Hospital closures in 2006/2011 0 0
Staffed inpatient beds per 100,000 pop 574.4 523
Hospital occupancy rate per 100 staffed beds 61.7 58.4
Psychiatric care beds per 100,000 pop 46.1 52.7
Median time from ED arrival to ED departure for admitted ED patients 217
State collects data on diversion NO NO

Disaster Preparedness

Title 2009
Report Card
Report Card
Per capita federal disaster preparedness funds $7.06 $5.89
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) NO YES
Special needs patients included in medical response plan YES YES
Patients dependent on medication for chronic conditions in medical response plan NO 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 NONE
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 NO YES
Statewide real-time or near real-time syndromic surveillance system YES YES
Real-time surveillance system in place for common ED presentations NO YES, STATEWIDE
Bed surge capacity per 1M pop 856.5 6,968.7
ICU beds per 1M pop 358 327.6
Burn unit beds per 1M pop 0 0
Verified burn centers per 1M pop 0 0
Physicians registered in ESAR-VHP per 1M pop 2.4 0
Nurses registered in ESAR-VHP per 1M pop 8.6 0
Behavioral health professionals registered in ESAR-VHP per 1M pop 0
Strike teams or medical assistance teams YES YES
Disaster training required for essential hospital/EMS personnel YES, YES NO
Percent of RNs that received emergency training 44.8 40.8

Medical Liability Environment

Title 2009
Report Card
Report Card
Lawyers per 10,000 pop 12.3 9.7
Lawyers per physician 0.7 0.5
Lawyers per emergency physician 15.5 10.6
ATRA judicial hellholes (2009 range 0 to -7/2014 range 2 to -6) -1 2
Malpractice award payments per 100,000 pop 1.8 2.3
Average malpractice award payments $244,128 $153,415
National Practitioner Databank reports per 1,000 physicians 21.4 33.7
Apology laws: Apology is inadmissible as evidence in a court of law NO
State has implemented a patient compensation fund NO NO
Number of insurers writing medical liability policies per 1,000 physicians 11.1 12.3
Average medical liability insurance premiums for primary care physicians $12,066 $7,062
Average medical liability insurance premiums for specialists $63,803 $36,223
Presence of pretrial screening panels NONE NO
Pretrial screening panel's findings admissible as evidence N/A N/A
Periodic payments are: required, granted upon request, at court's discretion AT JUDGE'S OR COURT'S DESCRETION AT COURT'S DESCRETION
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 YES YES
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
Pedestrian fatalities per 100,000 pedestrians
Percent of traffic fatalities alcohol-related
Percent of front occupants using restraints
Child safety seat/seat belt legislation - score out of a possible 10 points
Helmet use required for all motorcylce riders
Distracted driving legislation score - out of a possible 4 points
Graduated drivers' licenses legislation score -out of a possible 5 points
Percentage of children aged 19-35 months who are immunized
Percentage of adults aged 65+ who rec’d an influenza vaccine in the last 12 mos
Percentage of adults aged 65+ who ever rec’d pneumococcal vaccine
Fatal occupational injuries per 1M workers
Homicides and suicides (non-motor vehicle)(per 100,000)
Unintentional fall-related fatal injuries (per 100,000)
Fire/burn related fatal injuries (per 100,000)
Rate of unintentional firearm-related fatal injuries (per 100,000)
Rate of unintentional poisoning-related deaths (per 100,000)
Total injury prevention funds per 1,000 persons
Dedicated child injury prevention funding
Dedicate elderly injury prevention funding
Dedicated occupational injury prevention funding
Anti-smoking legislation score - score out of a possible 3 points
Infant mortality rate per 1,000 live births
Percentage of adults who binge drink
Percentage of adults who currently smoke
Percentage of adult population who are obese (BMI > 30.0)
Percentage of children who are obese
Cardiovascular disease disparity ratio
HIV diagnosis disparity ratio
Infant mortality disparity ratio

Quality & Patient Safety

Title 2009
Report Card
Report Card
Funding for quality improvement within the EMS system
Funded state EMS medical director
Emergency medicine residents per 1M pop
Adverse event reporting required
% of counties with Enhanced 911 capability
State has a uniform system for providing pre-arrival instructions
State uses CDC guidelines for state field triage protocols
State has or is working on a stroke system of care
State has triage and destination policy in place for stroke patients
State has or is working on a PCI network or a STEMI system of care
State has triage and destination policy in place for STEMI patients
State maintains statewide trauma registry
State has triage and destination policy in place for trauma patients
Prescription drug monitoring program score (range 0-4)
% of hospitals with computerized practitioner order entry
% of hospitals with electronic medical records
% of patients with AMI given PCI within 90 minutes of arrival
Median time to transfer to another facility for acute coronary intervention
% of patients with AMI who received aspirin within 24 hours
% of hospitals collecting data on race/ethnicity and primary language
% of hospitals with or planning to develop a diversity strategy or plan

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