Consumer choice can lower health care costs, but consumers need quality and price information to guide their decisions. And that information is often hard to come by.

President Bush has been urging transparency in the health care industry and has ordered federal agencies to make such information public.

Some groups are starting to organize this information into ratings.

Last month, a nationwide alliance of large employers that provide health insurance, the Leapfrog Group, published a list of the 59 top hospitals in the country.

None from Texas made the list.

The group's quality and safety survey asked more than 1,200 hospital administrators whether their physicians use computers to order patient therapies, whether they have an explicit protocol to ensure that enough nurses are on duty, whether intensive care units are staffed with ICU specialists, whether they vaccinate staff for the flu and whether they meet top standards for coronary artery bypass surgery and aortic aneurysm repair.

If every nonrural hospital in the country met these standards, more than 65,000 lives could be saved and more than 907,000 medication errors could be avoided, the Leapfrog Group estimates. It could also save the country $41.5 billion a year.

Insurance companies are also getting scrutinized. The National Committee for Quality Assurance, managed care's accrediting body, and U.S. News & World Report released rankings this month on 246 commercial insurance policy providers.

None from Texas made it into the top 50 health maintenance organizations.

The highest ranking for a Texas HMO policy provider was Scott & White Health Plan in Temple at No. 78.

Dallas-based Blue Cross Blue Shield of Texas, which has about 300,000 people in its HMO, came in next among Texas plans at 187.

The Dallas-Fort Worth Business Group on Health is trying to work up an evaluation guide for every physician in the area, along with a guide to treatment for chronic diseases such as diabetes.

Marianne Frazen, executive director of the group, says the guide should be available in January.

"Our next logical move would be into pricing," she said.

Jim Landers