APA/CHAMPUS peer review project: Implications for research and practice.

Abstract

In 1977, the American Psychological Association (APA) entered into a contract with the Civilian Health and Medical Program oj the Uniformed Services (CHAMPUS) to provide peer review oj psychological services as a mechanism oj'quality assurance. The peer review system is now fully operational and has been expanded to a number of private insurance earners. The history of the project, the operational details oj the system, and some of the criticisms that have been raised are described. Research has been performed that reflects on the system, particularly as to the theoretical orientation of the reviewer. This research is summarized, and areas of future research concern are outlined. Finally, the implications of a peer review system for the provider, the patient, and the profession are described.

A look backward: The peer review program of the American Psychological Association.

“…This study highlights peer review's consultative role (Strieker & Cohen, 1984) in that the providers in this study did receive copies of the peer reviews for their cases.…”

“…payers (Cohen & Strauss-Zerby, 1984;Strieker & Cohen, 1984;Theaman, 1984). The focus in this study was on one major insurance company's involvement.…”

“…The system was under APA peer review contract and was adapted from that used in the original APA/CHAMPUS peer review project. The reader is referred elsewhere for a history of the American Psychological Association's involvement in conducting peer review for third-party payers (Cohen & Strauss-Zerby, 1984; Stricker & Cohen, 1984; Theaman, 1984). The focus in this study was on one major insurance company's involvement.…”

“…Empirical research on psychological peer review has focused primarily on factors such as reviewers' and providers' theoretical orientation (Biskin, 1985; Cohen, 1981; Cohen & Oyster-Nelson, 1981; Cohen & Pizzirusso, 1982; Pizzirusso & Cohen, 1983) and on various characteristics of treatment documentation as they affect peer reviewers' judgments of the necessity and adequacy of reported treatment (Cohen, 1981; Cohen & Nelson, 1982; Cohen & Pizzirusso, 1982; Dall & Claiborn, 1982). Stricker and Cohen (1984) and Theaman (1984) provided literature reviews of these areas of research. With the exception of Dall and Claiborn's study (1982), all research was conducted under analogue experimental conditions.…”

An audit-evaluation of a school psychological services unit utilizing professional standards: An example.

“…The accountability approaches that have been developed in psychology recently have concentrated on peer review of independent providers, for example, the APA/CHAMPUS (Civilian Health & Medical Program of the Uniformed Services) project (Claiborn, Stricker, & Bent, 1982; Stricker & Cohen, 1984). A comprehensive review of methods for evaluating the performance of school psychologists using direct measures, perceptions of others, and change in others, was presented by Bennett (1980).…”