As a live kidney donor (in 2004), I have an interest in the quality and performance of organ transplant programs (Transplant rejections? May 21, p. 6). I thought your cover story treatment of the issue was balanced and objective; however, reporter Jennifer Lubell was a little soft in addressing some of the specific reasons why organ transplant programs have come under increased governmental scrutiny of late.
Like it or not, organ transplantation is governed by the fundamental economic laws of supply and demandtoo few organs from live or cadaver donors and too many people in need of organ transplants. Add to this natural economic tension the lucrative reimbursement opportunities for hospital organ transplant programs, and you get a recipe for the potential fraud and abuse of a system funded by taxpayers who want a legitimate return on their investment in healthcare services.
Yes, strictly speaking, volume does not equate with quality. However, numbers are an indicator of quality. Suppose a transplant program does a large number of transplants and also has a large number of negative outcomes associated with those transplants; statistically speaking, such a transplant program is not exhibiting quality through its performance. It begs the question: Is this program merely churning the Medicare system in order to receive federal dollars without any regard for treatment outcomes of either the organ recipient or the organ donor, if living?
Quality organ transplant programs have nothing to fear from these new Medicare conditions of participation. Rather, substandard organ transplant programs should either step up professionally or fold up their tents.
Corporate compliance officer
Community Memorial Healthcare