Florida governor candidate David Jolly says the state is 49th in ‘avoidable’ hospital costs. Is it?

In his bid to be Florida’s next governor, Democrat David Jolly is singling out the state’s healthcare system as leading most of the country in unnecessary and expensive hospital costs.

"More people are going without healthcare than ever before and as a result Florida is 49th in avoidable hospital costs — 49th," Jolly, a former Republican, said June 11 at Florida International University’s Graham Center in Miami. 

That raised our curiosity. Is Florida really a standout on this measure? And what is considered "avoidable"?

Jolly’s campaign pointed us to a September 2025 Florida Policy Institute article that referenced the statistic. "Florida ranks 49th in potentially avoidable hospital use and cost, meaning that the state pays more than others due to a lack of timely and effective care, preventive care, and health insurance," the article said, citing a June 2025 analysis by the Commonwealth Fund, a nonpartisan healthcare research organization.

The Commonwealth Fund evaluated state health systems across the U.S., including healthcare access and affordability, prevention and treatment and "avoidable hospital use and cost." 

The study accounted for the states and the District of Columbia, ranking Florida’s health system 39th overall and 49th in the avoidable hospital use and cost category, meaning its inefficiencies are among the nation’s most significant.

Jolly’s campaign said he was arguing for opening up more Federally Qualified Health Centers, nonprofit and county health clinics across the state to increase patient access to primary care and bring down healthcare costs.

David Radley, a Commonwealth Fund senior scientist and the report’s lead author, said the "avoidable hospital use and cost" category represents state health system efficiency, and includes some costs outside of hospital settings, such as for costly imaging that patients may not need and state Medicare spending.

How did the study measure avoidable hospital use and cost?

The Commonwealth Fund’s state healthcare system scorecard is part of a series of reports tracking how well health care systems are working for people in every state. Its 2025 report used 2023 data, the most recent available at the time.

The scorecard, which has been produced intermittently for more than a decade, includes over 50 measures broken down into various categories. Its avoidable hospital use and cost category examines potentially avoidable emergency department visits, outpatient care admissions for certain conditions, 30-day hospital readmissions, costly medical imaging and more. 

"That rank of 49 is basically the combined aggregate score where Florida ranks based on its performance on these components, which were chosen because they reflect, in some way, inefficient use of finite healthcare resources," Radley said.

For example, for the "potentially avoidable emergency room visits" metric, researchers incorporated a widely used tool from New York University that categorizes ER visits based on the medical urgency of patients’ diagnoses and treatments.

This breaks down the different things people may show up to the ER for, Radley said, ranging from emergent conditions such as trauma, heart attack and stroke to health issues that could have been treated by a primary care or specialty physician.

Another metric in the category, "admissions for ambulatory sensitive conditions," involves a list of certain disease complications, as designated by the Agency for Healthcare Research and Quality, that typically don’t require hospital admission if the underlying condition is being well managed. These include hospitalizations for certain complications of diabetes, chronic obstructive pulmonary disease, asthma and hypertension.

"If you're diabetic and you need your leg amputated, of course the hospital is the right place to be," Radley said, "but if that person has their disease being managed, and they are engaged with their doctors, they typically shouldn't get to the point where they need their leg amputated."

The "hospital readmissions within 30 days" measure includes situations in which people got discharged too early or didn’t receive appropriate follow-up care, resulting in their unnecessary readmission.

Hospital admissions are among the most expensive costs associated with healthcare. The average cost for a one-night hospital stay in Florida is around $3,060, according to KFF, close to the U.S. average of $3,297 per night.

Researchers  also evaluated how often patients receive costly, but unnecessary medical imaging. In many instances, less expensive X-rays or CT scans may show what a doctor needs to know without an MRI. An MRI can cost $500 to $1,000 and often get prescribed the first time someone shows up at the doctors, Radley said.

"A lot of times, these MRIs are happening for these conditions where there is really no real indication that an MRI is needed," Radley said. "At least not right away." 

Our ruling

Jolly said Florida is "49th in avoidable hospital costs."

This matches a 2025 Commonwealth Fund analysis that placed Florida 49th out of 51, accounting for the states and the District of Columbia, in its "avoidable hospital use and cost" category.

Researchers arrived at that ranking by studying the frequency of potential avoidable emergency department visits, ambulatory admissions for certain conditions, 30-day hospital readmissions and more.

The category also included data that wasn’t exclusive to hospitals, such as Medicare spending.

Jolly’s claim is accurate but needs some additional information. We rate it Mostly True.