House Committee Holds Hearing on Reforming America’s ‘Grossly Inefficient’ Organ Transplant System
Should there be reforms to the U.S. organ transplant system?
by Causes | 5.4.21
What’s the story?
- The House Oversight Committee’s Subcommittee on Economic and Consumer Policy held a virtual hearing Tuesday to examine the U.S. organ transplant system and reforms that are moving forward. The hearing ― titled “The Urgent Need to Reform the Organ Transplantation System to Secure More Organs for Waiting, Ailing, and Dying Patients” ― featured testimony from stakeholders including patients on a waitlist for a transplant, a doctor who is a living donor, and experts on the transplant system.
- There are 107,000 Americans on an organ transplant waitlist, 33 of whom pass away each day before a transplant becomes available. Additionally, there are hundreds of thousands of Americans who are undergoing dialysis and would benefit from a transplant but aren’t on a waitlist.
- Much of the hearing focused on the role played by the nation’s 57 non-profit Organ Procurement Organizations (OPOs), which are certified and regulated by the Centers for Medicare and Medicaid Services (CMS). OPOs are granted a monopoly over their designated region and focus on obtaining organs from deceased donors, which account for over 80% of transplants.
- One of the panelists, Dr. Dara Kass, is an emergency room doctor who served as a living donor to her young son, who suffered from a liver condition prior to receiving the transplant. Kass testified that both her personal and professional experiences underscored the need for OPO reform:
“We cannot overstate the urgency upon us in reforming the OPO system to ensure that it is functioning and accountable. As an ER doctor, I had repeatedly witnessed OPOs mismanage families, communicate poorly, and ultimately leave organ transplant patients languishing on the waiting list.”
- Matt Wadsworth, president and CEO of an OPO called Life Connection of Ohio, testified about the nature of the problems in the industry:
“As an industry, OPOs are grossly inefficient. For scale, peer-reviewed research finds that as many as 28,000 organs go untransplanted every year, with much of the problem owing to wildly variable OPO performance and severe, persistent failure at many OPOs which has gone completely unaddressed by regulatory bodies… As geographic monopolies, OPOs are not subject to any competitive pressures to provide high service, and as the only major program in all of healthcare 100% reimbursed for costs, we do not face financial pressures to allocate resources intelligently. OPOs are given blank checks and participation trophies as patients are given death sentences. It is truly hard to find a more important system with less accountability.”
- Chairman Raja Krishnamoorthi (D-IL) noted in his opening remarks that there have been some “disastrous” failures by OPOs:
“Kaiser Health found evidence of hundreds of organs delayed, damaged, or lost in transit. Last year, an OPO delivered lungs for transplant, but never tested a sample they collected for COVID. The lungs were infected with COVID, which killed the transplant patient. In another case involving two organs, the donor’s blood type was incorrectly identified ― tragically, one transplant recipient died, and the other was gravely injured.”
- Ranking Member Michael Cloud (R-TX) noted in his opening remarks that a recently finalized regulation will increase oversight of OPOs:
“In response to President Trump’s executive order calling for more reforms of the organ procurement system, the Centers for Medicare and Medicaid Services issued a final rule in December. After a brief pause from the Biden Administration and thanks to the chairman and the work of this committee, the Biden Administration, just about a month ago, reissued the rule. The rule aims to increase the performance standards for OPOs and threatens decertification for lackluster performance.”
- Under the rule, new performance and outcome measures for OPOs will be implemented starting in 2022, and OPOs will be accountable for the new measures for recertification purposes in 2026.
— Eric Revell
(Photo Credit: iStock.com / sturti)
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