PSRO, which stands for Professional Standards Review Organization, refers to a regulatory body established under the Social Security Act in the United States during the 1970s. The primary purpose of a PSRO is to monitor and assess the quality, appropriateness, and necessity of medical care provided to Medicare beneficiaries. This organization is responsible for reviewing healthcare services provided by hospitals, nursing homes, and other healthcare facilities to ensure compliance with established medical standards and guidelines.
A PSRO typically consists of a group of healthcare professionals, including physicians, nurses, and other specialists, who collectively evaluate medical records, treatment plans, and other pertinent information to determine the quality and appropriateness of care delivered. They may also analyze the utilization of healthcare resources and make recommendations for improvement.
The PSRO program was established to control rising healthcare costs, reduce unnecessary medical procedures, and safeguard the interests of Medicare beneficiaries by ensuring they receive appropriate and high-quality care. PSROs work in collaboration with healthcare providers to identify areas where clinical practices can be enhanced, cost-effectiveness achieved, and unnecessary medical interventions prevented.
However, it is essential to distinguish PSROs from current organizations involved in healthcare quality evaluation and improvement, as their authority and functioning have evolved over time. The term "PSRO" is now less commonly used, as quality assessment and improvement organizations have undergone several transformations and are now better known by different names, such as Quality Improvement Organizations (QIOs).
