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February 19, 2003

Public Disclosure of Health Plan Quality of CarePublic Disclosure of Health Plan Quality of Care

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(7):845-847. doi:10.1001/jama.289.7.845-a

To the Editor: In their discussion of disclosure of HEDIS quality scores, Dr McCormick and colleagues1 appear to assume that HMOs can influence the quality of medical care. I believe that there is insufficient evidence for this assumption.

The HEDIS measures were initially designed to compare the cost and quality of health care delivered to capitated populations by a homogeneous group of tightly managed staff and group model HMOs. It is questionable whether current health plans—which typically involve large, overlapping heterogeneous networks of physicians, hospitals, and clinics—can influence the quality of care delivered to populations they serve. McCormick et al imply that HMOs deliver medical care, when in fact they act more as insurance companies. It is physicians, not health plans, who provide care for patients.

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