Thesis

The design, implementation and operation of a statewide peer review organization for Medicare

With the advent of Federal legislation, as defined in the Peer Review Improvement Act of 1982, Title I, Subtitle C of the Tax Equity and Fiscal Responsibility Act of 1982, Public Law 97-248, a contract with a organization will be negotiated to provide for the assumption and implementation of the functions of a statewide Utilization and Quality Control Peer Review Organization (PRO). The objective of this graduate project focuses on the development of a proposal for such a Statewide Professional Review Organization (SPRO) which meets the technical requirements specified in the Health Care Financing Administration Request for Proposal (RFP) No. HCFA-84-015. This graduate project provides a complete description of review requirements for Medicare as well as displaying in depth data analysis statistics for Medicare utilization trends for the all hospitals in the state of California. (See more in text.)

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