CHA Health (CHA) is a provider-owned managed care plan serving a predominantly rural membership in Kentucky. Quality Oncology, Inc. is a national disease management company specializing in cancer care. This paper reports the results over the first 2 years of a cancer disease management program installed at CHA. The authors also review the evidence-based health services research that has guided the development and implementation of the program. The authors conclude that cancer is a disease state where specialized management can improve efficiency, treatment effectiveness, patient coordination, and outcomes reporting.

As a sufferer from fairly severe hay fever, I read with great interest the article by Johnstone et al.,1 hypothesizing a connection between general anesthesia and respiratory allergy. My interest was heightened because I underwent a hernia repair at Strong Memorial Hospital at age 16 months. The article by Ballantine et al.2 in the same issue leads me to believe that I should have had my operation in Boston. The two articles are absolutely contradictory.