Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 1 § 60.2
PRO Responsibility for the Overall Approach to Health Care
60.2 - PRO Responsibility for the Overall Approach to Health Care
(Rev. 1, 09-11-02)
In addition to individual case review, PROs also help providers improve the overall approach to
health care for Medicare beneficiaries.
This function includes the following activities:
•
Using clinical and other data bases to examine patterns of care and outcomes, rather than
focusing on isolated cases;
•
Identifying systemic variations of concern or interest by monitoring patterns of care and
outcomes;
•
Working with providers to identify provider-specific root causes of systemic variations;
and
•
Working cooperatively with the health care community to measurably improve the
processes and outcomes of care for Medicare beneficiaries.