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	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: We believe that the Special Communication on publicly reporting quality information by Drs Werner and Asch¹ incorporates a misleading presentation of the literature.

First, the study in which "patients undergoing bypass surgery in Pennsylvania and New York had lower illness severity than patients in states that did not publicly release the information . . . "² had a contrived design that used total hospital expenditures for any reason in the year prior to bypass surgery. The study by Hannan et al³ that they cited examines the issue in the correct way by looking at immediate preoperative severity of illness and changes in preoperative severity of illness over time. This study found that between 1994 and 1999, New York and Pennsylvania had greater increases in the percentages of (1) Medicare coronary artery bypass graft (CABG) patients who were 80 years of age and older and (2) patients who had a myocardial infarction . . . [Full Text of this Article]

Edward L. Hannan, PhD, MS
eln03@health.state.ny.us
Department of Health Policy, Management, and Behavior
University at Albany School of Public Health
Albany, NY

Mark R. Chassin, MD, MPP, MPH
Department of Health Policy
Mount Sinai School of Medicine
New York, NY

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