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1993.05.11 :  PROs -- Comparative Information on Medical Strategies

FOR IMMEDIATE RELEASE                   Contact:  Anne Verano
Tuesday, May 11, 1993                             (202) 690-6145

       Medicare Peer Review Organizations will soon be able to
provide doctors and hospitals with comparative information on
different medical strategies used by their counterparts across
the country to treat illness and injury.
       Reducing the focus on case-by-case quality reviews of
hospital inpatient care, PROs will emphasize analysis of patterns
of care that vary among health care providers and different
geographic areas. 
       "We want to know why the care of Medicare beneficiaries in
some hospitals, communities, states and regions produces better
outcomes than the practices in other areas," said HHS Secretary
Donna E. Shalala.
       Using computer technology, the PROs will be identifying
and seeking causes for variations in hospital mortality rates,
readmission rates, length of hospital stays and other phenomena.
       "The comparative data furnished to doctors and hospital
personnel will strengthen the ability of PROs to help providers
develop strategies to improve both care and outcomes," Secretary
Shalala said.
       The PROs, organizations of physicians operating in every 
state and territory under contracts with Medicare, monitor the
quality of care furnished to Medicare beneficiaries in hospitals.

       The analysis of patterns of care has already been started
by PROs in 15 states: Arkansas, Colorado, Delaware, Illinois,
Kansas, Mississippi, Nevada, New Hampshire, New York, Ohio,
Oregon, Pennsylvania, Tennessee, Utah and West Virginia. All
others will be performing that activity by Oct. 1.
       In addition to reviewing patterns of care on many medical
conditions, the PROs will conduct a special project of building
an extensive data base on treatments and outcomes of patients
with ischemic heart disease and those who have sustained acute
myocardial infarctions (heart attacks).
       The groundwork for this project was laid by researchers at
Duke and Harvard universities, conducting studies supported by
the federal Agency for Health Care Policy and Research. 
       For the PRO work in the coronary studies, the AHCPR is
serving as a consultant to the Health Care Financing
Administration, which directs the Medicare program and PRO
activities.
       The AHCPR, a part of the Public Health Service, leads the
HHS-wide effort to improve the appropriateness and effectiveness
of medical care.  

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EDITOR'S NOTE: HCFA, an agency of the U.S. Department of Health
and Human Services, directs the Medicare and Medicaid programs,
which help pay the medical bills of 67 million Americans. HCFA's
estimated fiscal year 1993 expenditures are almost $230 billion.