Who runs this website and how do I know the information is reliable?
MNHealthScores is brought to you by MN Community Measurement, an independent, non-profit community organization. Our mission is to accelerate the improvement of health by publicly reporting health care information. Since 2002, we have collected, analyzed and evaluated health care quality information from Minnesota doctors and clinics. We have published that information online for the public since 2004. We have facilitated the State of Minnesota's mandatory health care reporting program since 2008. And our work has repeatedly been recognized by federal programs and national organizations, including the National Quality Forum, Robert Wood Johnson Foundation and the Centers for Medicare and Medicaid Services.
The information provided on MNHealthScores is objective, unbiased and validated. It cannot be manipulated by outside groups, including the clinics, medical groups and hospitals whose information is reported here.
Where is this information collected from?
The information displayed is collected from clinic, medical group and hospital electronic medical records; insurance company claims databases; and patient and medical group surveys. Data submitted directly from clinics and medical groups is validated for accuracy before it's posted on MN HealthScores.
- Clinic and medical group electronic record information is submitted directly to MN Community Measurement's custom built, secure Data Portal for the Asthma, Colorectal Cancer, Diabetes, Depression and Vascular care measures.
- The Healthcare Effectiveness Data and Information Set (HEDIS) uses insurance company claims to measure performance. It's collected by the National Committee for Quality Assurance (NCQA), and MN HealthScores publishes the results for medical groups in Minnesota. This is the data source for many of the medical group measures.
- The Minnesota Hospital Association collects information for hospitals based on Agency for Healthcare Research and Quality (AHRQ) recommendations. Through a partnership with MHA, MN HealthScores publishes the information. This is the data source for most of the hospital measures.
- Patient experience information for clinics is submitted directly to MN Community Measurement from survey vendors who administer AHRQ's Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. This is the survey that often arrives in the mail soon after you went to the doctor's office and asks you about your experience. Patient experience information for hospitals uses a similar survey, known as the Hospital CAHPS survey. MN HealthScores publishes this information through our partnership with MHA.
- Health information technology information is submitted directly to MN Community Measurement by medical groups through a survey that asks detailed questions about their use of electronic medical records.
What is high quality care?
High quality health care means getting the right care, at the right time. It's care that does not harm you, is based on medical research, and is appropriate for your condition or illness. When high quality care is received, patients who are sick get better and patients who are healthy stay healthy. According to the Institute of Medicine, there are six major elements of high quality care: safety, effectiveness, patient-centered, timely, efficient and equitable.
Why is it important to rate the quality, cost and patient experience of health care providers?
Measuring the quality of health care is the first step to improving it. The information can help consumers make health care decisions, can help clinics know where to focus quality improvement efforts, and can help public health officials and policymakers understand the impact of clinical care on the overall health of Minnesotans.
How can this information help me?
There are many factors that go into selecting the doctor, clinic or hospital that's right for you. MNHealthScores provides you with information about the quality of care and experience you can expect from each clinic or hospital. It's important to remember that the ratings on this site are statistics gathered from thousands of patients over time. They are not necessarily a predictor of your care or experience, but should be part of the things you consider when choosing a health care provider.
What does the HealthScore mean for clinics and medical groups?
The HealthScore is a category that signals how a clinic or medical group compares to the statewide average for that health topic.
- Top signifies the top 15 clinics or medical groups for that measure, as long as the clinic or medical group's rate is above average. There may not be 15 with a Top HealthScore if there are not 15 above average rates.
- Above Average means the clinic or medical group has a rate and confidence interval (also known as a margin of error) above the statewide average for that measure.
- Average means the clinic or medical group has a rate and confidence interval (also known as a margin of error) that are equivalent to the statewide average for that measure.
- Below Average means the clinic or medical group has a rate and confidence interval (also known as a margin of error) below the statewide average for that measure.
- Not Reportable means there is no information to report for that clinic or medical group for that measure.
The scale is different for each health topic we're measuring because we're comparing the clinics or medical groups to the statewide average. For example, the statewide average for Colorectal Cancer Screening is 69%. All clinics above 69% will have a top or above average rating. But the statewide average for Diabetes Care is 39%. All clinics above 39% will have an top or above average rating, even though that same rating might be Below Average for Colorectal Cancer Screening.
What does the HealthScore mean for hospitals?
The HealthScore is a category that signals how a hospital compares to the statewide average for that health topic.
- Above Average means the hospital's rate is above the statewide average and confidence interval (also known as a margin of error) for that measure.
- Average means the hospital's rate is equivalent to the statewide average and confidence interval (also known as a margin of error) for that measure.
- Below Average means the hospital's rate is below the statewide average and confidence interval (also known as a margin of error) for that measure.
- Not Reportable means there is no information to report for that hospital for that measure.
It should be noted that there is no Top category for hospitals.
Why are there different averages for different conditions or screenings?
The rates for individual clinics, medical groups and hospitals are based on the number of patients that provider saw for that particular health condition or procedure during a specific time period, as well as how many of those patients received the recommended care. As a result, each provider has a different mathematical equation to determine their rate and each measure has a different equation to determine the statewide average.
Additionally, it's important to take into account the uniquenesses of each condition. For example, the Depression: Feel Better (6 Month) measure rates are very low; the statewide average is 8%. For many patients, depression is a lifelong, chronic condition and so the rate of having few to no symptoms six months after treatment is low. This is in stark contrast to the Sore Throats: Children measure, where the statewide average is 89%. This measure focuses on whether doctors obtain a throat culture to test for strep throat before prescribing antibiotics to children with sore throats, which is easier for the clinic or medical group to control.
Where does the statewide average come from?
MNCM calculates the statewide average for all clinics, medical groups or hospitals in Minnesota by looking at the results across the state and dividing by the number of entities.
What does Expected Rate mean?
The expected rate is what we would expect that clinic or medical group's rate to be given the mix of patients being seen if the clinic or medical group were providing average quality of care. The rate is adjusting for differences in risk among specific patient groups by looking at factors such as patient age, diabetes type or insurance type (as a rough proxy for socioeconomic status). These factors will impact patients health outcomes and their ability to obtain recommended care, even if they clinic or medical group is providing the best possible care. For example, despite a clinic or medical group doing everything in its power to get a low-income patient screened for colorectal cancer, research shows the clinic or medical group will have a lower rate of success due to other barriers in that patient's life (e.g. transportation challenges, inflexible work hours, lack of childcare). This does not change the care that the clinic or medical group should provide to patients; it is designed to isolate the clinic or medical group's true impact on the health of their patients - thus allowing clinics and medical groups to be more easily compared. This process is called risk adjustment.
The insurance groups used for this adjustment are Medicare, Medicaid, Self-Pay/Uninsured and Commercial. There is variation in socioeconomic status within each of these categories that is not accounted for by this risk adjustment model. Thus, the risk adjustment will not fully account for patient socioeconomic status in providers that serve a disproportionately at-risk population within these categories. MNCM continues to evolve this process over time with a multi-stakeholder workgroup.
What is a reporting period?
The period of time during which the visits to a doctor's office or hospital occurred. The reporting period for each measure is noted on the Measure Detail page.
Why don't all clinics, medical groups and hospitals have the same information? Why do some say "Not Reportable"?
There are several reasons why a clinic, medical group or hospital would be listed as Not Reportable.
- Some are determined to be ineligible for certain measures because they do not provide that type of care. For example, an urgent care clinic is unlikely to be evaluated for colorectal cancer screenings, a preventive test, because urgent care does not generally provide preventive care to patients.
- Some submit information but do not have enough patients who received that type of care to qualify for reporting on MNHealthScores. For most measures, a clinic, medical group or hospital must have at least 30 patients that received a particular type fo care to be reliable enough to report publicly. Fewer patients can lead to inaccurate and misleading information about that doctor's office.
- Some choose not to provide us with information. While most clinics and medical groups are required by the Minnesota Department of Health to provide information to MNCM, there are some that refuse.
- Clinics that have been recently bought by or merged with another clinic or medical group may not be listed due to providing information under the old clinic's name.
How up-to-date is the information about which clinics doctors belong to and clinic contact information?
All clinics and medical groups whose information appears on our site are required to register with us annually. This is when we receive updated location and contact information, as well as the list of doctors currently working at that office. Most clinics and medical groups register in the fall, although registration can occur at any time during the year for new clinic locations or clinics that have not previously given MNCM information.
How often are the rates updated?
Most are updated annually. Clinic patient experience information is updated every other year.
Do the rates stay the same from year to year?
No. Each clinic, medical group or hospital's rating can go up or down based on how successful or unsuccesful they are in providing high quality care.
How do doctors use this information?
The information on MNHealthScores helps doctors and clinics improve the care they provide to all patients by targeting the areas where they need improvement. Clinical quality improvement professionals use the data, as well as more detailed information provided directly to clinics and medical groups, to target new processes and innovations that improve the quality of the care delivered in their clinics.
Why can't I find ratings of individual doctors on this site?
Most patient care and experience require a team of people, so isolating the care by individual doctor can be difficult and misleading. Consider all of the people you interact with during a simple doctor's visit: schedulers, greeters, nurses, doctors, sometimes additional doctors, lab or x-ray technicians, pharmacists, etc. Clinic-level ratings are the best way to evaluate the care and experience provided by the entire team at a particular location.
Do clinics have to give you information?
No, but most Minnesota clinics do contribute data to MN Community Measurement. Minnesota has an innovative and collaborative health care community, so many clinics and medical groups voluntarily submit data to support quality improvement initiatives. Additionally, the Minnesota Department of Health requires most primary care clinics to submit information on a wide variety of health topics to them through MN Community Measurement.
Why do clinics that don't seem to fit my search show up in my results?
Any clinic that provides the care or procedure being evaluated is asked to submit information. Some specialty clinics provide general care as well, so they appear in results for conditions and procedures outside their specialty.
Who else works on health care quality in Minnesota?
Minnesota has a long history of ground-breaking and nation-leading work in health care measurement and improvement. MNCM is proud to work with many partner organizations in our collective effort to improve health for all Minnesotans. Our partner organizations include the Institute for Clinical Systems Improvement, Stratis Health, Minnesota Medical Association, Minnesota Hospital Association, Minnesota Council of Health Plans and Minnesota Health Action Group. We also work in close collaboration with the Minnesota Department of Health and Department of Human Services on efforts to improve care in Minnesota.
Who else works on health care quality nationally?
There are many state and local organizations, like MNCM, which provide health care information that can help patients in other areas of the country make decisions. A list of similar organizations can be found at the Network for Regional Healthcare Improvement (NRHI).
In addition to NRHI, the Centers for Medicare and Medicaid Services tracks and provides information on health care quality for many clinics, medical groups and hospitals around the country. And other major health care quality organizations such as the American Health Quality Association, The Joint Commission, The Leapfrog Group, National Committee for Quality Assurance, Agency for HealthCare Research and Quality and National Quality Forum provide various reports and information.
I can't find information on a topic that I am researching. What should I do?
MNCM is constantly working on identfiying, cultivating and implementing new measures that will benefit the Minnesota medical community and consumers. Visit Advancing the Future to learn about some of the things we'll be releasing soon. We also welcome ideas of health topics that you'd like to see us provide information on in the future. Please send your thoughts to firstname.lastname@example.org.
Still have a question?
Please send other questions to email@example.com and we'll promptly respond to you. Thank you!