Author Contributions: Dr Trivedi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Trivedi, Zaslavsky, Ayanian.
Acquisition of data: Trivedi, Ayanian.
Analysis and interpretation of data: Trivedi, Zaslavsky, Schneider, Ayanian.
Drafting of the manuscript: Trivedi, Zaslavsky.
Critical revision of the manuscript for important intellectual content: Trivedi, Zaslavsky, Schneider, Ayanian.
Statistical analysis: Trivedi, Zaslavsky, Ayanian.
Obtained funding: Trivedi, Ayanian.
Study supervision: Schneider, Ayanian.
Financial Disclosures: Dr Zaslavsky reports having received funding from the CMS for implementation and research on the Medicare Consumer Assessments of Health Plans beneficiary surveys. Dr Schneider reports having served on advisory panels convened by the National Committee for Quality Assurance and the CMS. Dr Ayanian reports that he is a consultant to RTI International on clinical risk adjustment models for Medicare health plans. No other disclosures were reported.
Funding/Support: This study was supported by an institutional National Research Service Award (5 T32 HS000020-20) and grant (P01-HS10803) from the Agency for Healthcare Research and Quality, by an institutional National Research Service Award (5 T32 HP11001-15) from the Health Resources and Services Administration, by the Primary Care Research Fund of Brigham and Women's Hospital, and by a Bridge Award from Harvard Medical School.
Role of the Sponsors: The funding organizations had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript.
Acknowledgment: We are grateful to Robert E. Wolf, MS, and Matthew Cioffi, MS, Harvard Medical School, for statistical and programming support; to Kim Elmo, BS, and Judy Giles of the CMS for assistance with data acquisition; and to the Research Data Assistance Center at the University of Minnesota for advice on obtaining Medicare data.