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July 14, 2004

Fee-for-Service vs Managed Care Medicine—Reply

Author Affiliations

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

JAMA. 2004;292(2):170. doi:10.1001/jama.292.2.170-b

In Reply: Dr Howe argues we should have adjusted for pharmaceutical use because beneficiaries who use multiple medications would be attracted to MMC plans for their prescription drug coverage and then face rising premiums.

As we stated in our article, our survey is designed to measure consumer experiences with specific aspects of care, irrespective of benefit design. The fact that some Medicare beneficiaries may have had premiums that were higher than expected should not affect their reports about specific care experiences that are unrelated to prescription drug benefits. With the possible exception of the overall rating of the plan (or Medicare), the specific ratings and composites that we used (Table 1 in our article) are unrelated to drug coverage or premiums.