American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy Brief

College suggests improvements for HCFA’s PRO program

From the March 2001 ACP-ASIM Observer, copyright © 2001 by the American College of Physicians-American Society of Internal Medicine.

The College has suggested that HCFA’s peer review organizations (PROs) expand the clinical areas they focus on and link their quality improvement activities to the growing efforts of governmental agencies and others to reduce medical errors.

In a Feb. 1 letter to the director of HCFA’s Quality Improvement Group, the College made the following suggestions:

  • PROs should add three new clinical areas to the six national quality initiatives already underway. The three areas are chronic obstructive pulmonary disease; hip fractures; and counseling on weight loss, smoking cessation, alcohol abuse and general nutrition for diabetics and the frail elderly.

  • PROs should link their quality-improvement activities to efforts by the government and others to reduce medical errors. The College said that HCFA needs to make sure that PROs’ efforts are integrated with the patient safety initiatives of the Agency for Healthcare Research and Quality, the National Quality Forum and the Joint Commission on Accreditation of Healthcare Organizations.

  • PROs should expand their role in Medicare’s beneficiary complaint process. The College recommended that HCFA make more beneficiaries aware of and improve access to the complaint process. The College also asked for HCFA to establish uniform standards that PROs must use when investigating complaints and reporting any subsequent findings to beneficiaries.

The full text of the College’s letter is available on ACP-ASIM Online at www.acponline.org/hpp/7th_scope.htm.

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