New Report Shows Post-Pandemic Decline in Many Key Minnesota Health Care Quality Measures

December 20, 2023

Childhood immunizations among the largest impacts

A new report from MN Community Measurement (MNCM) finds that while several measures of preventive health care and care for acute and chronic conditions improved in 2022, some key measures worsened and only one has improved compared to pre-pandemic levels. MNCM is an independent non-profit that serves as an objective, trusted source of information on Minnesota health care quality, cost, and equity.

The report,  Minnesota Health Care Quality Report Part 2: Clinical Quality Measures Reported by Payers   ,  includes 2022 data for eleven measures of preventive care like immunizations and cancer screening as well as care for acute and chronic health conditions. MN Community Measurement collected the data from ten health plans that provide insurance coverage in Minnesota. In addition to statewide averages and trends presented in the report, a detailed set of appendix tables includes results for each quality measure by medical group.

Key Report Findings

  • In 2022, statewide performance rates improved for four measures and declined for three. The largest improvement was seen in appropriate prescribing of antibiotics for acute bronchitis (7.5 percentage points), and the largest decline was in immunizations for children (4.9 percent points).
  • Compared to pre-pandemic levels (2018 data), seven of the eleven measures included in the report were significantly worse in 2022, and one measure (immunizations for adolescents) was better. The biggest declines compared to pre-pandemic performance were for measures of spirometry testing for diagnosis of chronic obstructive pulmonary disease, or COPD (9.4 percentage point decline) and childhood immunizations (8.0 percentage point decline).


Childhood Immunizations

The measure used in the MNCM report for childhood immunizations represents the percentage of children who received a series of recommended vaccinations by their second birthday and is also referred to as the Childhood Combo 10 immunization rate. It is important to better understand the factors driving the large decline in this measure in 2022 and compared to pre-pandemic levels. According to Steven Inman, MD, a practicing pediatrician and Medical Director for Children’s Health Network, a majority of the decline in the childhood immunizations measure has been driven by children missing influenza vaccinations. Dr. Inman is also a member of MN Community Measurement’s Board of Directors.

According to Dr. Inman, in 2020 the Covid-19 pandemic resulted in a greater than usual increase in Childhood Combo 10 immunization rates at Children’s Health Network as parents worried about Covid-19 vaccinated their children for influenza in greater numbers due to fear of the “triple pandemic” (Covid-19, RSV and Influenza).  In 2022, the Children’s Health Network Combo 10 rate was down 4.8 percentage points from its peak in 2020 driven in large part by a 5.9 percentage point decrease in the influenza immunization rate.  Because the Combo 10 measures vaccines given over a 2-year period the “Covid-19 bump” persisted somewhat in the 2021 measure year, but now we are starting to observe the effects of declining influenza immunization rates. “Unfortunately, that trend has continued. Through October 2023, the Children’s Health Network influenza immunization rate is down 9.3 percentage points from the 2020 peak, which may be an indicator that the statewide rate for the Combo 10 measure will decline further in 2023,” said Dr. Inman. The data from Children’s Health Network represent a combination of pediatric practices that are reported separately by MNCM.

Overall Trends

“It’s clear from the findings in this report and  earlier findings from MNCM  that there is still a lot of work ahead to get important measures of health care quality back to where they were prior to the COVID-19 pandemic,” said Julie Sonier, MNCM President and CEO. “In addition, the medical group level results in this report show that there is substantial variation and room for improvement even beyond that baseline.”

Importance of Measurement

Measuring and reporting on health care cost, utilization, and quality helps consumers understand how care varies across providers, allows providers to identify improvement opportunities and how their measures compare to others, and helps health plans and other purchasers better understand and improve value for money that is spent on health care.

“Minnesota is unique in the capabilities that we’ve built to measure and report on a robust set of measures related to health care cost, utilization, quality, and disparities,” said Sonier. “Having a common set of priorities and common set of data have been huge assets to our state in focusing efforts to drive improvement.”


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October 20, 2026
MINNEAPOLIS, Minn. — October 20, 2026 — MN Community Measurement (MNCM) today announced that it has completed its acquisition of Koble-MN's health information exchange (HIE) business line and the MNSHINE brand from The Koble Group. On November 1, MNCM will officially change its legal name to Minnesota Statewide Health Information Network and Exchange, known as MNSHINE. The transition follows a special joint meeting of MNCM's Board of Directors and members on October 12, at which the Board unanimously approved resolutions authorizing the acquisition, changing the organization's legal name, and establishing a new HIE Advisory Committee. Members unanimously adopted the name change and related amendments to the organization's Articles of Incorporation and Bylaws. An intentional decision to collaborate The transition is the result of an intentional decision by Minnesota health care leaders to collaborate on a health data landscape that makes sense: one that reduces redundancy, increases efficiency, and delivers needed information to those with legal authorization to receive it, where and when it is needed, without unnecessary administrative barriers. "This is not simply a merger of services. It is a deliberate choice to build the kind of health data infrastructure Minnesota deserves," said Liz Cinqueonce, President and CEO of MNCM. "For too long, organizations across our state have had to navigate duplicative systems and disconnected data. By bringing measurement and exchange together, we can reduce that burden and make sure the right information reaches the right people at the right time, with patient privacy protections firmly in place, so they can focus on improving care." The effort builds on months of work by the Executive Leadership Council, convened earlier this year by MNCM, the Minnesota Electronic Health Records Consortium, and Koble to explore how a sustainable, statewide health data utility could serve the public interest. "Minnesota is at its best when we take on difficult challenges together and align on solutions," said Mark Steffen, MD, Chair of the MNCM Board of Directors. "The Board's unanimous support reflects a shared conviction that our future depends on organizations keeping their unique strengths and missions while participating in shared infrastructure and governance. That balance is what enables greater coordination, transparency, efficiency, and impact." A trusted backbone for Minnesota's health data Minnesota's future health data ecosystem is one in which organizations retain their unique strengths and missions while participating in shared infrastructure and governance. The vision for MNSHINE is to become the health data utility, governed in the public interest with strong privacy protections and transparency, that serves as the trusted backbone connecting these efforts, ensuring data can be used more effectively to improve health, wellbeing, and outcomes for all Minnesotans. By bringing the measurement of health care quality, cost, and utilization together with the infrastructure that moves clinical data between organizations, MNSHINE will be positioned to support providers, payers, public health, researchers, policymakers, and communities alike, each within the limits of applicable law and participant agreements. The goal is healthier people, stronger communities, greater equity, better public decisions, smarter investments, and a health system that learns continuously. Continuity for HIE participants HIE services will continue without interruption. To ensure continuity of leadership and relationships, Chad Peterson, CEO of The Koble Group, has joined MNCM as Senior Vice President of HIE Services. “For HIE participants, this transition opens new possibilities,” said Peterson. “When exchange and measurement are guided by one mission, we can reduce duplication for providers and better support care coordination, while holding firm to the privacy protections patients expect. I’m proud to help lead that work, and I’m committed to making sure every participant feels supported as we grow.” MNCM has also established the HIE Advisory Committee as a standing committee of its Board of Directors. The committee continues the work of the Koble-MN Advisory Committee and will advise the Board on interoperability, participant relationships, privacy, security, data governance, and health equity. 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