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To the Editor: Dr Thompson and colleagues¹ concluded that "most commercial health plans do not deliver high-quality care" to Medicaid members. However, this conclusion was based on 1999 data for all Medicaid plans reporting to the National Committee for Quality Assurance Quality Compass, which does not represent the status of current plan practices. Also, no adjustment was made for known socioeconomic and ethnic differences between the 2 plans and there was no mention of different benefits and networks—even within the same company.

The authors stated that the influence of sociodemographic characteristics "may be overstated," yet it has been previously reported² that low income and poorly educated individuals were less likely to receive services such as childhood and adolescent immunizations within commercial plans alone. There are known racial and ethnic disparities in access to services among children and adolescents,³ and low socioeconomic status has been found to increase several risk factors . . . [Full Text of this Article]

Dawn Wood, MD
dawn.wood@wellpoint.com

Darius Jatulis, MS
State Sponsored Programs
Blue Cross of California
Thousand Oaks

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