ABSTRACT
This chapter offers a ranking of American states based upon the timing of their adoption of major health care policy reforms. It aims to determine which states are pioneers in the adoption of health care policy reforms, which states are followers and which states are laggards. The chapter analyses the role of the problem environment, political factors and regional influences to predict the timing of innovations in the dynamic area of health care policy. Diffusion of innovations among states was the main focus of Jack Walker’s landmark study in 1969 which attempted to construct a theory as to why some states adopted innovations more readily than others. An innovation score following the design of Canon and Baum was initially created using a composite score for each state based on timing of its adoption of the eight health care reforms. A record of policy liberalism in a state is strongly correlated with the early adoption of major health care reforms.
