This Article  • References  • 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  • Similar articles in JAMA  Social Bookmarking   What's this?

Theodore Kastner, MD
Columbia University College of Physicians and Surgeons New York, NY

Timothy McBride, PhD
University of Missouri at St Louis

Roger Acheatel, MD
Escondido Cardiology Escondido, Calif

JAMA. 1996;276(16):1298-1299.

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

To the Editor.

—Dr Keeler and colleagues¹ provide us with insight into patient behavior in choosing between fee-for-service (FFS) and MSA options. Using the RAND Health Insurance Experiment model, they demonstrate that the likelihood of market segmentation as a result of MSAs, with healthy consumers choosing health insurance programs that offer financial incentives, depends on the size of the MSA deductible: specifically, the larger the deductible, the larger the market segmentation. However, the effect of managed care (MC) on market segmentation, when compared with the MSA and FFS options, is not described.

We have modified the Figure contained in their analysis to highlight consumer behavior in choosing among FFS, MSA, and MC options. In our Figure, the MSA and FFS lines are similar to those in Keeler et al. The less steep slope of the FFS line reflects the presence of a co-payment. The MC option is shown as a horizontal line, . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?