This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

Physicians are influenced by many factors other than health plan guidelines. Although the presence or lack of insurance may influence a patient's ability to . . . [Full Text of this Article]

RELATED ARTICLES

Public Disclosure of Health Plan Quality of Care
Karen Ignagni
JAMA. 2003;289(7):845.
EXTRACT | FULL TEXT  

Public Disclosure of Health Plan Quality of Care
L. Gregory Pawlson
JAMA. 2003;289(7):845-846.
EXTRACT | FULL TEXT  

Public Disclosure of Health Plan Quality of Care
Onyebuchi A. Arah
JAMA. 2003;289(7):846-847.
EXTRACT | FULL TEXT  

Public Disclosure of Health Plan Quality of Care
Danny McCormick, David U. Himmelstein, Steffie Woolhandler, David H. Bor, and Sidney M. Wolfe
JAMA. 2003;289(7):847.
EXTRACT | FULL TEXT  

Relationship Between Low Quality-of-Care Scores and HMOs' Subsequent Public Disclosure of Quality-of-Care Scores
Danny McCormick, David U. Himmelstein, Steffie Woolhandler, Sidney M. Wolfe, and David H. Bor
JAMA. 2002;288(12):1484-1490.
ABSTRACT | FULL TEXT  

Association of Managed Care Market Share and Health Expenditures for Fee-for-Service Medicare Patients
Laurence C. Baker
JAMA. 1999;281(5):432-437.
ABSTRACT | FULL TEXT  

The Economist's Model of Physician Behavior
Uwe E. Reinhardt
JAMA. 1999;281(5):462-465.
EXTRACT | FULL TEXT