Regulation

New quality measures, new incentives for transplants.

CMS IN LATE NOVEMBER finalized a rule that revamps quality reporting measures with the goal of boosting transparency in the organ procurement and transplantation process.

The rule updates the Organ Procurement Organization Conditions for Coverage needed to be reimbursed by Medicare and Medicaid. The final rule is designed to help the more than 100,000 people in the U.S. on a waiting list for a lifesaving organ transplant, according to CMS.

The rule creates two new objective measures designed to increase incentives to use all available organs and to transplant them. One measures the number of organs an organ procurement organization, or OPO, has gotten from eligible donors in its donation service area. The other measures the rate of transplantation as opposed to procurement of the organs alone. The previous measures created a disincentive to go after all available organs.

Also under the new rules, underperforming OPOs will compete for their contracts and the worst performers will be unable to renew their contracts, the CMS said in a release. There are 58 OPOs in the U.S., each with its own designated area.

The Association of Organ Procurement Organizations said it supports the overall goal of creating valid metrics, but expressed disappointment in the final rule. “Unfortunately, the final rule fails to address most of our concerns with the flaws in the design of the new metrics, including the use of a flawed data set,” said Steve Miller, the group’s CEO. “We look forward to working with other stakeholders to improve these metrics and ensure there is no disruption in the world’s best donation and transplantation system.” ●