The dynamics among HMOs, hospitals and costs in Massachusetts are worth the attention of healthcare executives, researchers and reformers. We believe, however, that your coverage of this rapidly evolving situation ("Higher costs in HMO-land," June 27, p. 102) may have created some misperceptions, which we would like to correct.
When the amount spent per person for hospital care, physicians' services and prescription drugs in Massachusetts is compared with per-capita income of residents, healthcare costs in Massachusetts fall below the national average. In 1991, HHS estimated that healthcare costs in the state were 10.5% of per-capita income, compared with a national average of 11.5%.
The article's figures on Boston also were misleading. In 1992, average costs per admission and per diem in Boston were 9.2% and 11.8% higher, respectively, than U.S. metropolitan averages. The article's figures, which show far greater differences, are misleading because they compared urban hospitals and academic medical centers with the average American hospital.
H. RICHARD NESSON, M.D.
Chairman, Massachusetts Hospital Association
President, Brigham and Women's Hospital
J. RICHARD GAINTNER, M.D.
Chairman, Conference of Boston Teaching Hospitals
President, CEO, New England Deaconess Hospital Corp.