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Call to Develop a Standard Acquisition Charge Model for Kidney Paired Donation
Author(s) -
Rees M. A.,
Schnitzler M. A.,
Zavala E. Y.,
Cutler J. A.,
Roth A. E.,
Irwin F. D.,
Crawford S. W.,
Leichtman A. B.
Publication year - 2012
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2012.04034.x
Subject(s) - medicine , donation , reimbursement , organ donation , transplantation , organ procurement , beneficiary , kidney transplantation , tissue typing , united network for organ sharing , procurement , actuarial science , business , finance , surgery , marketing , health care , law , human leukocyte antigen , immunology , antigen , political science , liver transplantation
We propose a Medicare Demonstration Project to develop a standard acquisition charge for kidney paired donation. A new payment strategy is required because Medicare and commercial insurance companies may not directly pay living donor costs intended to lead to transplantation of a beneficiary of a different insurance provider. Until the 1970s, when organ procurement organizations were empowered to serve as financial intermediaries to pay the upfront recovery expenses for deceased donor kidneys before knowing the identity of the recipient, there existed similar limitations in the recovery and placement of deceased donor organs. Analogous to the recovery of deceased donor kidneys, kidney paired donation requires the evaluation of living donors before identifying their recipient. Tissue typing, crossmatching and transportation of living donors or their kidneys represent additional financial barriers. Finally, the administrative expenses of the organizations that identify and coordinate kidney paired donation transplantation require reimbursement akin to that necessary for organ procurement organizations. To expand access to kidney paired donation for more patients, we propose a model to reimburse paired donation expenses analogous to the proven strategy used for over 30 years to pay for deceased donor solid organ transplantation in America.