Editorial: Don't surrender on key health care tool

Minnesota shouldn't give up on its first-in-the-nation attempt to publicly rank state hospitals and clinics by the quality and cost of the care they provide.

Lawmakers need to make sure these comparisons are credible and accurate, but they also need to give this pioneering "health care report card" effort a chance to work through the challenges bound to accompany any complex, groundbreaking undertaking.

Consumers and employers faced with mounting medical insurance premiums deserve to know where they're getting the best value for their dollars. More detailed information can also help providers improve care and deliver it more efficiently.

That's why this comparison was part of Minnesota's ambitious 2008 state health reform package, which enjoyed bipartisan legislative support and was signed by then-Republican Gov. Tim Pawlenty.

Unfortunately, this powerful new consumer tool is now a political target at the State Capitol. Some of the state's most influential health care lobbies have legitimate concerns about the comparison's early methodology and data collection.

But lawmakers need to resist premature measures to permanently weaken the results or table them indefinitely until the methodology is perfect.

One measure likely to be pushed by the Minnesota Medical Association would analyze cost and quality variations by geographic area or by population group instead of providing more useful comparisons by provider name, which is known as "provider peer grouping."

And because the Minnesota Department of Health is spearheading the comparison, the state's medical-privacy advocates have objected to the reform. The information collected and analyzed, however, does not contain identifiable information about patients. Nor do the data represent a patient's medical record, as some have claimed.

The questions raised about peer grouping get technical fast. But solid legislative leadership by Republican Rep. Steve Gottwalt has given providers' concerns the public airing they deserve. Gottwalt chairs the House Health and Human Services Reform committee, which held a packed hearing last month on the issue.

Legislators clearly had heard from health provider constituents and gave voice to their concerns. Key problems with the early analysis: incomplete information, providers' inability to verify data, and "forced variation" -- a problem in which provider rankings may unfairly magnify very slight differences among them.

That's a big problem in a state with so many top-notch health providers.

But it was also clear that health officials have worked with providers -- or are working with them -- to address these issues. On the forced-variation issue, for example, health officials acknowledged that there is a problem and are seeking more statistically valid ways to report findings.

Legislators who approved provider peer grouping in 2008 had the right idea -- give consumers the tools to spend their health care dollars wisely. The science and practicality of delivering this information still lags behind this lofty goal.

Minnesota's rocky start is to be expected, but it's insufficient reason to strangle this promising project in its infancy.

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