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Medical care value purchasing is the latest effort to promote cost containment while maintaining or enhancing the quality of medical care. The fuel driv ing this process is mandated health care cost and quality data disclosure to stimulate competition in oversupplied markets so that the highest...
Delegation of Medicare peer review authority to hospital committees contributed to the failure of Professional Standards Review Organizations. The financial incentives of prospective payment under Diagnosis-Related Groups are associated with partic ularly aggressive hospital-based review and...
The Medicare and Medicaid laws were intended to eliminate inferior medical care for the elderly and the indigent. The success of these programs, however, has led to more expense than the government had anticipated. To control this cost, the government has designed several utilization review...
The author examines the concept of a Quality As surance/Utilization Review residency program from the perspective of a program director in an estab lished specialty. Quality Assurance/Utilization Re view could develop into a specialty that is oriented heavily toward administration. In order to...
The Medicare database, which is comprehensive, current, and easily manipulated by computer tech nology, contains enormous amounts of information regarding hospital and physician practices. Access to the Medicare database greatly increased with the es tablishment of the Peer Review Organization...
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