Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Ms Ignagni and Dr Pawlson criticize
us for using older HEDIS data. At the time our study was submitted in June
2001, NCQA had released neither HEDIS 2001 nor 2002. Moreover, we doubt that
inclusion of more recent data would substantially alter our conclusions.
According to Pawlson, the percentage of plans withdrawing from public
disclosure declined in 2001 and 2002. He lauds a 1999 NCQA policy change that
required public disclosure for plans newly seeking formal accreditation. While
we applaud this policy, it scarcely resolves the problem because accreditation
remains optional. Low-scoring plans can still manipulate the process by forgoing
accreditation or by withdrawing from HEDIS altogether. Hence, the actual proportion
of plans whose scores are hidden from public view is far higher than Pawlson
and Ignagni suggest. While the dropout rate has been lower in the past 2 years,
the percentage of plans that submitted HEDIS scores to NCQA but refused public
disclosure was still 27% in 2001 and 18% in 2002 (written communication, Communications
Department, NCQA, December 10, 2002). Moreover, in 2002, only 336 of the 500
HMOs listed in the InterStudy HMO Directory1 submitted
HEDIS scores to the NCQA, and 62 of these refused to allow public disclosure
of their scores (written communication, Communications Department, NCQA, December
10, 2002). Thus, only 55% (274/500) of HMOs in the United States disclosed
McCormick D, Himmelstein DU, Woolhandler S, Bor DH, Wolfe SM. Risk of Cutaneous Vaccinia From Health Care Workers Who Receive Smallpox Vaccine. JAMA. 2003;289(7):845–847. doi:10.1001/jama.289.7.845-a
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: