Vermont offers the best Medicaid services for individuals with intellectual and developmental disabilities while Mississippi provides the worst, according to an annual ranking released Thursday.

The 50-state analysis from United Cerebral Palsy compares services offered across the country, giving preference to states where more individuals are served in the community as opposed to institutions.

Vermont, Arizona, Michigan, New Hampshire and California fare best in the ranking. Meanwhile, the District of Columbia, Illinois, Texas, Arkansas and Mississippi round out the bottom of the list.

However, the report authors caution that no state is perfect, writing “although some states rank better than others, every state has room for improvement.”

As in previous years, states at the top of the ranking do not fit one profile. They are both large and small, wealthy and poor. Moreover, they have varying tax structures and differ significantly in the amount they spend on Medicaid home and community-based services waivers.

Since last year’s report, more than 2,000 Americans with disabilities moved out of institutional settings and into the community, according to the most recently available data, much of which is from 2009. And, Michigan became the tenth state to have no large institutions.

Still, the number of people on waiting lists for services continues to rise — up 56 percent between 2005 and 2009, according to the report.