To the Editor: In analyzing the association
of for-profit status with HMO medical quality, Dr Himmelstein and colleagues1 avoid a logical conclusion in favor of a provocative
one. Finding that not-for-profit HMOs outperformed investor-owned HMOs in
each of 14 NCQA measures, they conclude that the profit motive causes reduced
quality. Even if one accepts as plausible the idea that the participating
physicians would independently limit immunizations and other care (none of
the measured services require precertification), what is puzzling is the idea
that HMOs could so successfully execute such a delicate objective. In an industry
in which performance measures can yield a grab bag of results, inducing HMO
physicians to perform well enough to secure accreditation, but poorly enough
to save the profit margin, is quite a trick.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.