- Pressure to meet federal performance standards is causing hospitals to discard less-than-perfect organs and deny extremely ill patients transplants that could extend the length and quality of their lives, according to a Stat report.
- Between 2007, which is when the government set standards for transplants, and 2012, more than 4,300 people were dropped from organ transplant waiting lists—86% more than in the five years preceding the standards, a study published in Journal of the American College of Surgeons shows.
- The fear is that imperfect organs and very sick patients increase the odds of poor outcomes, which can impact a hospitals’ performance rating and reimbursement.
Earlier this year, the United Network for Organ Sharing (UNOS) reported the number of organ transplants in the U.S. exceeded 30,000 in 2015 and donations totaled more than 9,000. Both numbers were record-high.
Yet 22 people die every day while waiting for a organ transplant, according to the White House, which announced in June new actions for research on reducing the organ waiting list with $200 million in funding.
“It’s gut-wrenching and mind-boggling,” transplant surgeon Adel Bozorgzadeh at with the University of Massachusetts Medical Center in Worcester, who coauthored the study in the Journal of the American College of Surgeons, told Stat
In addition to fewer people getting transplants, the trend has led to 20% more kidneys being tossed.
CMS has acknowledged that declining to perform riskier transplants improved some hospitals’ ratings, narrowing the margin of error, and making it increasingly hard to meet performance expectations.
In May, the agency revised its policy so that transplant centers that remain within 150% and 185% of the standard would be deemed “standard-level” violation, subjecting them to increased monitoring, but not financial penalties that accompany a “condition-level” deficiency.
Reversing the trend could have financial as well as healthcare implications. Keeping people alive on dialysis costs Medicare more than providing them with transplants, Stat notes.