American Journal of Clinical Nutrition, Vol 60, 800-800, Copyright © 1994 by The American Society for Nutrition

Erratum

AM Coulston, C Rosen. American health care reform: implications for medical nutrition therapy. Am J Clin Nutr 1994;59:1275-6. The third paragraph in the right-hand column of page 1275, which continues on page 1276, should read:

Under many of the reform proposals federally sanctioned managed competition plans will feature prepaid health policies approved by regional health care alliances. The primary care provider (PCP) will become the central figure managing the patient and the money set aside for the patient's yearly health care (ie, capitation). Current managed care programs permit the physician to choose how to spend a fixed amount of money. However, only a minority of PCPs and few insurance carriers recognize the importance of medical nutrition therapy. When applying the managed care model globally, it appears highly unlikely that patients will be referred for nutritional consultation. Furthermore, it would be unrealistic to rely on busy PCPs to render those services, because most are either unfamiliar with the medical nutrition model or do not have the time. For example, faced with treatment options for a pregnant woman with gestational diabetes mellitus, few PCPs would choose to refer her for nutritional assessment and treatment to enhance traditional medical therapy under the current health care delivery system. Throw in a financial incentive by health maintenance organizations for PCPs not to refer patients, and it is unlikely that providers will use their valuable dollars on medical nutrition.