Review: feedback about practice patterns for measurable improvements in quality of care--a challenge for PROs under the Health Care Quality Improvement Program.

The Health Care Quality Improvement Program (HCQIP), administered by the Health Care Financing Administration and implemented through Utilization and Quality Control Peer Review Organizations (PROs), is a new approach to monitoring the health care received by Medicare beneficiaries. The HCQIP shifts the focus of the PRO program from regulatory quality management to quality improvement principles. Through a series of cooperative projects, each focusing on a specific medical condition or procedure, PROs will conduct pattern analysis and share information about these analyses with health care organizations for the purpose of stimulating internal quality improvement efforts. As a fundamental shift in the way PROs have conducted quality-related activities, the HCQIP presents PROs with numerous challenges. This paper provides insight into one of their most significant challenges, the development of a model for constructive, nonevaluative feedback. Successful HCQIP feedback efforts may serve as models for quality management programs that will accompany national health care reform.