Minnesota has the nation's best health care system, according to an authoritative new federal analysis of hospitals, clinics, nursing homes and other medical providers.

The state ranked first in care at medical clinics, fourth in care at hospitals, eighth in nursing homes but 43rd in home health care -- the state's lowest rank and a category whose low score for years has puzzled state officials. Overall, Minnesota ranks third for care of patients with acute conditions, seventh for chronic care and 11th for preventive care.

"For more than five years we've had an intense collaboration among providers, health plans, state officials and others to tackle both quality and cost issues," said Jennifer Lundblad, president of Stratis Health, a nonprofit with government and industry contracts to help improve health care delivery in Minnesota.

"That's hard work ... and this report confirms where we're doing well and where we still need to improve."

Wisconsin, which ranked first last year, fell to second -- trading places with Minnesota. Iowa ranked sixth, North Dakota eighth and South Dakota 11th. At the bottom was Texas, coming in behind West Virginia, Arkansas, Oklahoma and New Mexico.

The "state snapshots" are part of an annual report by the federal Agency for Healthcare Research and Quality designed to improve medical care while placing quality data in consumers' hands.

The report grades providers using widely accepted practice measures, such as the percentage of heart attack patients who received recommended care at the hospital or the percentage of children who received recommended vaccinations. Since it was first issued in 2006, the report has placed Minnesota among the top three states.

'Strong' or 'very strong'

Many types of care in Minnesota improved last year, and many rank in the top categories of "strong" or "very strong," although the report shows the state is weak in home health care and maternal and child care.

The report found that care improved for patients with diabetes, heart and respiratory diseases, but fell slightly for cancer patients.

Minnesota's score at 67.31 of a possible 100 is the highest any state has achieved. Last year it scored 64.46. Some of the data is available online at the Medicare.gov website, with tools that help people compare nursing homes, home health care agencies and dialysis centers.

"Minnesota and the federal government are getting better and more sophisticated at gathering and analyzing this kind of information," Lundblad said. "The more open and effective we can be at sharing this information, the better job we all will do."

Warren Wolfe • 612-673-7253