Can the psro's be cost effective? A study of the effect of the Commonwealth Health Agencies monitoring program on the length of stay of Medicaid patients in Massachusetts

Abstract

To analyze the effect of the Commonwealth Health Agencies Monitoring Program on the length of stay of a sample of Massachusetts Medicaid patients, we compared their experience with that of non-Medicaid patients. We found a consistently decreasing trend in the length of stay of Medicaid patients during the 2 1/2-year period studied. The average length of stay of Medicaid patients decreased by 11.9 per cent relative to the norm, whereas the non-Medicaid length of stay decreased by only 6.6 per cent. We infer that the Program may be credited within the 5.3 per cent differential decrease. The consistency and reliability of the data suggest that similar results may be extrapolated to the hospitals not sampled. We conclude that Professional Standards Review Organizations, of which this program was a precursor, can be cost effective, given an expanded review mandate and the application of suibable evaluative processes.