Towards a standard acquisition charge for living donor kidney exchange

The U.S. Agency for Healthcare Research and Quality has awarded a grant to the Alliance for Paired Donation to explore a standard acquisition charge for living kidney donors.

(See this paper for a description of the problem:  Call to develop a standard acquisition charge model for kidney paired donation. Rees MA, Schnitzler MA, Zavala EY, Cutler JA, Roth AE, Irwin FD, Crawford SW, Leichtman AB, Am J Transplant. 2012, Jun; 12(6), 1392-7.)

Here's part of the press release:

 "A pilot project led by The University of Toledo that could increase the number of kidneys available for transplant by the thousands and save U.S. taxpayers millions if implemented nationwide has been funded by the U.S. Agency for Healthcare Research and Quality.

 “Many tests need to be conducted to ensure that a kidney donor and recipient are compatible and that it is safe for the donor to donate,” said Dr. Michael Rees, a University of Toledo Medical Center transplant surgeon and principle investigator of the four-year, $2 million grant. “One of the primary barriers to greater kidney availability is that once an insurance company or Medicare learns that Donor A’s kidney isn’t compatible with Recipient A, they stop funding the tests and no transplant occurs.

“This grant will enable us to create an entity that pays to complete Donor A’s tests, which allows us to discover that Recipient B in another part of the country is compatible,” Rees said. “Once Donor A gives to Recipient B, the insurance company for Recipient B will reimburse the entity for the cost of Donor A’s tests. In a similar way, it may be Donor K or Donor W who ultimately ends up being compatible with Recipient A.”

"Rees estimated that if such a model was expanded nationwide, as many as 1,000 to 3,000 additional kidney transplants would be possible each year.

“The savings to Medicare and insurance companies could reach into the hundreds of millions of dollars due to the elimination of regular treatments like dialysis and other medical efforts for those waiting for an organ,” Rees said.

"To execute the pilot project, UT will partner with the Southwest Transplant Alliance and the Alliance for Paired Donation, an organization founded by Rees to help incompatible kidney donors and recipients find alternative compatible matches. The Alliance for Paired Donation is a Northwest Ohio-based not-for-profit entity that has partnered with more than 80 transplant centers across America to find matches for their patients.

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"Gold and Rees thanked U.S. Senator from Ohio Rob Portman and Congresswoman Marcy Kaptur for their help in advocating for the value of the grant to those in need of a kidney transplant.
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"By establishing a standardized charge nationwide for the compatibility testing, removal and transplantation of a kidney, the United States could remove the business disincentive currently in place that inhibits kidney donations across states, across different insurance companies, and between Medicare and Medicaid and private insurers, Rees said.

“This grant will show this idea can work,” Rees said. “The next step will be convincing all parties involved that the concept works and then scaling this project up to the national level using the experience gained to save thousands of lives and millions of dollars every year going forward.”

"In June, Rees and UTMC earned national acclaim for coordinating the first international altruistic kidney donation chain. An earlier chain that began in 2009 has also been covered by People Magazine and published in the New England Journal of Medicine.