What do Minnesota hospitals have to hide?

  • Article by: EDITORIAL BOARD , Star Tribune
  • Updated: May 16, 2014 - 6:31 PM

The state's medical centers should release quality, cost report cards.

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Groundbreaking report cards on Minnesota hospital care costs and quality were released this spring on a confidential basis to the medical centers that were graded and compared with their peers. Come this fall, these marks were supposed to be shared with the public, which entrusts its health care to these institutions.

But unless the state’s hospitals actually follow through on rhetoric about transparency and better “value” for health care dollars, far too few of these Hospital Total Care reports will see the light of day outside of hospitals’ executive offices. The reason: regrettable newly passed legislation that suspended the “provider peer grouping” medical report project and the requirement that the work be made public after hospitals had a chance to review or appeal their scores.

The 96 hospitals that received these scores still have the option to release these reports, along with any caveats about the findings. The legislation, a setback for health reform in Minnesota, doesn’t change that. Hospitals ought to make this information available instead of making self-serving excuses about why they can’t. (Thirty-nine medical centers, such as children’s specialty hospitals, were not scored.)

Filing away these reports, which is what almost all of the hospitals that received them plan to do at this point, is a disservice to Minnesotans. Health care consumers not only deserve to know how their medical centers fared, they have a real need to do so. In this age of high-deductible health coverage, consumers should have all available information to help them decide which providers deliver quality care at competitive prices.

Policymakers also need access to the reports. It’s a tool that could help inform them as they oversee billion-dollar medical assistance programs and as demand for these services soars with an aging population.

Hospital officials should realize that sitting on the information raises an unflattering question: What do they have to hide? The public is left to conclude that those who aren’t releasing the information didn’t do very well. Is that what Mayo Clinic, Allina Health, Essentia Health, HealthPartners and Fairview Health Services want their patients to believe?

Asked this week for their reports, these organizations either declined or steered an editorial writer to the Minnesota Hospital Association (MHA). The industry organization said it’s not recommending that members release the information. Officials raised questions about methodology that have dogged provider peer grouping almost since the Legislature passed it as part of the state’s landmark 2008 health reforms.

They also argued that quality and cost-of-care information is available elsewhere and may include more recent hospital data. In Minnesota, the industry-funded Minnesota Community Measurement nonprofit has done respected work in this area. National-level efforts also exist. But these efforts lack the localized, detailed and comprehensive big picture that the state effort provided.

Health care is plagued not by an abundance of data but by a lack of data, particularly user-friendly information about where consumers can get good value for their dollars. The state reports were not perfect, but they were a strong start, with methodology improved with extensive industry input.

In the report released by Ridgeview Medical Center, which may be the only hospital system to have made this information available, the Waconia-based provider received a quality score of 92 (out of 100), compared with an average score in Minnesota of 88. A key benchmark found its costs 14 percent lower than average for peer hospitals. Ridgeview also received high marks for customer satisfaction.

Prospective patients would find these overall scores useful and would be interested in some of the more detailed ratings of Ridgeview’s processes, such as heart attack care or infection control. Ridgeview president and CEO Robert Stevens merits praise not only for his sincere commitment to health care transparency, but also for his advocacy of consumers’ ability to understand the information and take into account concerns about methodology.

This week, HealthEast officials said they are strongly considering releasing their reports. Other Minnesota hospital systems need to follow Ridgeview’s lead. The conversation about cost, quality and value in health care is only going to intensify. Minnesota providers need to help lead that discussion — not hold it back.

  • Industry ‘pushback’

    “Minnesota has ... experienced pushback from payers and providers concerned that publicly available comparisons may adversely impact their market share and revenue.”

    January 2014 Robert Wood Johnson Foundation report on setbacks to Minnesota’s provider peer grouping reports.

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