HSAs and PSROs: can the odd couple learn to live together?

The Health Policy Program, UCSF School of Medicine, has conducted a two-year study of possiblities for cooperation between Health System Agencies (HSAs) and Professional Standards Review Organizations (PSROs). This paper, which is based on that study, focuses on two areas in which it may be impossible for either program to do its work properly without help from the other. HSAs cannot do health planning without the kind of data that can only be generated by the PSRO network. In turn, it may be hopeless for PSROs to try to change utilization practices unless HSAs can hold down the supply of beds and services. In spite of their interdependence, cooperation to date between HSAs and PSROs has been limited by their different membership, by restrictions on release of PSRO data, and by ineffectual HSA tools to control supply. With increasing government cost-control pressures, HSAs and PSROs are likely to find it necessary to work together as their activities begin to impact on each other.