Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—Drs Allen and Foldes and Drs
Rich and Kralewski reiterate a point we previously made: that physician ratings
of health plans could be confounded by various factors. They cite plan type,
whether physicians are employed by a plan, and underlying attitudes toward
managed care as particularly problematic. We agree that if such confounding
occurs it should be addressed. However, because this pilot study was limited
to 3 plans in the Twin Cities metropolitan area (where there is only 1 staff
model HMO), it was not possible, as Allen and Foldes recognize, to control
for plan type. There are no well-established methods to control for physicians'
attitudes toward managed care. We currently are launching a national multisite
study that will enable us to determine whether such confounding exists and
to control for it.
Borowsky SJ, Davis MK, Lurie N. Physicians' Ratings of Health Plans—Reply. JAMA. 1998;279(3):193-194. doi:10.1001/jama.279.3.193