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Letters
November 17, 1999

Disclosure of Physicians' Financial Incentives—Reply

Author Affiliations
 

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(19):1814. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-19-jbk1117

In Reply: As we stated in our article, we agree with Dr Temianka that fee-for-service incentives can lead to inappropriate treatment and also should be disclosed. Citing numerous studies, we discussed the challenge presented for requiring mandatory disclosure because existing data do not provide a definitive conclusion about the relationship between financial incentives and the quality of health care or the services provided.

At the same time, managed care incentives are less visible to patients than fee-for-service incentives, less familiar, more complex. Disclosure of managed care incentives also may have significant consequences for patient trust and the physician-patient relationship. For all these reasons, disclosure of managed care incentives demands more attention. Our article sought to inform consideration of the important issues facing physicians, health plans, and policymakers as disclosure mandates are implemented across the nation.

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