Release results of Attorney General Keith Ellison's Sanford-Fairview probe

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Controversy engulfed the proposed Sanford-Fairview merger soon after the plan was announced late last year, with two former governors among those sounding the alarm about an out-of-state entity controlling the University of Minnesota Medical Center.

Now that the merger has collapsed, Minnesota Attorney General Keith Ellison should swiftly release the results of his months-long investigation into the deal. Minnesota taxpayers paid for the inquiry, and they deserve to know the results.

Did the attorney general's office find reasons to challenge the deal? If so, what were they?

The findings may have important implications for policymakers. In this age of health care consolidation, this won't be the last merger proposed here.

Is the state's regulatory framework robust enough to safeguard assets like the U's teaching hospital and protect consumers from the higher costs that too often accompany this industry trend? Lawmakers made improvements this year but more may be needed.

On Thursday, Gov. Tim Walz announced a task force that will focus on next steps for the U's health sciences program. It's a sensible step after the Sanford merger fell through last month. Walz chose well in appointing retired Minnesota Health Commissioner Jan Malcolm to lead the effort.

Malcolm is state government veteran known for pragmatic leadership, but she'll have her hands full. The task force will operate on a tight deadline — perhaps too tight — with findings slated for January 2024.

Chief among the issues the group's members will tackle is whether the U's medical center should continue its partnership with Fairview, pursue a new collaboration with another health care system or chart some other course.

The U sold its hospitals to Fairview in 1997, and the current operating agreement runs through 2026. One issue that remains a source of contention is Fairview's financial support for research and physician training. These payments come to $90 million annually. This includes a $50 million fixed payment, a performance-based variable of around $10 million, and another $30 million generated by fees Fairview collects on services provided by University of Minnesota Physicians.

A key question for Malcolm and the task force: Should the state instead shoulder this support when many health care systems are struggling financially?

In a recent interview with an editorial writer, Fairview President and CEO James Hereford said he believes "there remains incredible potential in the integration of academic medicine with a community-based care delivery system like Fairview."

But he added, "That said, any new partnership we enter into with the University of Minnesota must satisfy the twin objectives of achieving the ability to compete in a very challenging market that includes the delivery systems like Allina and Mayo, and the University of Minnesota's key role in serving public health through its teaching and research missions."

That's likely an argument for reducing Fairview's financial support for the U's medical education and research should the partnership continue. (To read the full interview, go online to tinyurl.com/hereford-qa.)

The attorney general does not make public an ongoing investigation's findings. In response to an editorial writer's inquiry about releasing the Fairview-Sanford information, a spokesman for the office provided a previous statement from Ellison:

"In my office's ongoing investigation, we have done significant work to evaluate the proposed merger's compliance with state and federal laws and whether it is in the public interest, including reviewing more than 300,000 pages of documents. While this merger will not be going forward, the health and future of Fairview, the University of Minnesota healthcare facilities, and all Minnesota health systems are of vital interest to all Minnesotans. Much work remains to be done."

In addition to informing the gubernatorial task force, releasing the findings would help lawmakers and the public better understand the high stakes involved in this deal and how others like it could impact medical costs and quality of care.

It would also shed light on a specific Minnesota concern as health care consolidation continues. The number of nonprofit medical centers serving the state is admirable. But it also means that charitable contributions and preferential tax treatment have nurtured many institutions for decades.

What would happen to these assets if another out-of-state entity tries to acquire another Minnesota health care system?

These are important but dauntingly complicated issues. The attorney general's findings would help provide a factual foundation for the crucial health care decisions that lie ahead.