The effectiveness of pro cardiac pacemaker review in reducing implantation in the Medicare population.

Cardiac pacemaker insertions experienced an explosive growth in utilization following the introduction of this highly beneficial technology. Cost considerations prompted critical evaluation of the appropriateness of their use and raised the specter of potential abuse. The Connecticut Peer Review Organization (CPRO) program of pacemaker review to Medicare patients, based on physician input, criteria setting, dissemination of information, and specialist peer review, resulted in a dramatic reduction in the insertion of permanent pacemakers with minimal need for denials and appeals.