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July 21, 1999

Managed Care Market Share, Fee-for-Service Medicare, and Information Theory—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(3):235-236. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-3-jac90006

In Reply: A complete understanding of the ways managed care can influence the structure and functioning of the health care system is crucial as we seek to come to grips with the implications of the increase in managed care and develop appropriate policies to enhance the functioning of the health care system. Dr Blanco and colleagues' suggestion that information theory can help explain my finding that increases in HMO activity reduce expenditures even for non-HMO patients helps expand the arsenal of explanations available to researchers and policymakers. It is quite plausible that the activities of managed care organizations influence the information that patients, even non–managed-care patients, have about health conditions and potential treatments, and that this could be a mechanism by which managed care activity influences overall care patterns. (A sentence to this effect was even included in early drafts of the manuscript, but was later edited out for space.)