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Essay / Research Paper Abstract
A 24 page research paper that answer 5 questions pertaining to government regulation of health care and the ethics of MCOs and their gatekeeping function in regards to the health care system. Bibliography lists 16 sources.
Page Count:
24 pages (~225 words per page)
File: D0_khgovmco.rtf
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Unformatted sample text from the term paper:
PROs : In 1982, the statutory authorization for PSROs (Professional Standards Review Organizations) was repealed. In its place, the Department of Health and Human Services
(DHHS) was authorized to contract with PROs (Peer Review Organizations), which had many of the same basic functions of its predecessors, that is, to review the "quality, necessity, and appropriateness
of services paid by Medicare" (Wing, 2003, p. 130). As with the PSRO system, the efficacy of the PROs has been limited by both technical and budgetary limitations, as well
as by the gradual decline of its political support. The original PSRO legislation was envisioned as an "ambitious effort to police both
the cost and the quality of services" offered in the US health care system (Wing, 2003, p. 129). However, in implementation, the program bore only a partial resemblance to its
original design. The PRO system was essentially an attempt by the government to achieve the same goals with some structural changes. PRO areas were larger, frequently covering a whole state
and the states role under the PSRO program was virtually eliminated (Wing, 2003). In the 1990s, a trend developed in which individual
PROs began to focus on particular types of services for intensive review. By the end of the decade, the activities of the PROs began to "more closely resemble focused research
projects than efforts to police the necessity or effectiveness of actual services," with the role of the PRO as a regulatory agency disappearing almost entirely (Wing, 2003, p. 130). Due
to this assessment by Wing, it seems evident that PROs have failed in their original objective and, therefore, it is logical to conclude that they have either been either neutral
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