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MedPAC Calls for Peer Review Organizations to Improve the Quality of Rural Health Care

WASHINGTON, D.C., June 15, 2001 - MedPAC, the federal advisory commission on Medicare issues, has called for a stronger effort to assure the quality of health care for beneficiaries in rural areas. Specifically, MedPAC is recommending that the Department of Health and Human Services (HHS) use the national network of Medicare Peer Review Organizations (PROs) to improve rural health care quality.

MedPAC's recommendations for improving rural health care are the focus of the Commission's June 2001 report to Congress. In its report, MedPAC recommends that HHS Secretary Tommy Thompson "require the peer review organizations to include rural populations and providers when carrying out their quality improvement activities." The report says, "It is not the Commission's intent to shift the direction of national quality improvement activities." Rather, MedPAC recommends expanding the PROs quality improvement efforts in rural areas, "which may require additional funding to meet their new responsibilities."

The PROs are community-based quality improvement organizations working under contract to the Health Care Financing Administration (HCFA) at HHS. PROs work collaboratively with hospitals and doctors nationwide to assist in the adoption of best medical practices and to stimulate system-wide reforms to improve patient safety.

In its report, MedPAC stresses that the current Medicare system is designed so that the PROs have more incentive to focus on large, national urban projects rather than smaller rural based providers. This system needs to be modified, MedPAC asserts, because "Medicare should seek to ensure high-quality care for all beneficiaries, regardless of where they live."

The MedPAC report says that rural providers face less pressure to improve performance because they have fewer local competitors, and are less likely to be part of HMOs or participate in purchaser coalitions' efforts to address quality. Additionally, small rural providers are not likely to have the necessary resources to devote to quality improvement. The PROs, MedPAC concludes, can augment these limited resources and have a critical impact.

PROs work under three year contracts that define the scope of their work. MedPAC calls on Secretary Thompson to include objectives in the PROs' next scope of work -which is to be determined later this year - that set guidelines for performing quality improvement projects in rural areas.

The American Health Quality Association represents quality improvement organizations, medical Peer Review Organizations, and health care professionals working to improve the quality of health care nationwide.