HCFA's peer review agencies turn collegial, but keep clout.

The evolving peer review format, called the Health Care Quality Improvement Program, uses CQI techniques to ensure quality of care for Medicare recipients instead of the more punitive, case-by-case method used traditionally. The program offers opportunity to measure hospitals against widely accepted standards of care, against organizations of comparable size, against statewide averages, and against national averages. PROs can still assess fines and recommend removal of physicians from Medicare.