Ninety-seven percent of American leukemia, lymphoma and other blood-cancer-related transplants are done in hospitals, but Medicare and Medicaid are proposing increases in transplant-operation reimbursements that fail to cover many hospital costs, according to a national transplant donor organization.
Dr. Jeffrey W. Chell, head of the National Marrow Donor Program (NMDP), is one of the medical professionals shaking his head over the Centers for Medicare & Medicaid Services plan.
An American is diagnosed with a blood cancer such as such as leukemia or lymphoma every three minutes, the NMDP said. And someone dies of one every 10 minutes, which translates to 148 deaths a day.
The Minneapolis-based NMDP operates the national Be The Match Registry, a list of potential bone marrow donors and donated umbilical cord blood that could be used in transplants.
The Centers for Medicare & Medicaid Services (CMS) raised their reimbursement rates for transplant operations done on an out-patient basis. But they failed to include similar increases in their proposed changes for 2018.
A key problem is that the hospital reimbursement rates they are proposing for next year will fail to cover the cost of obtaining bone marrow and cord blood, Chell said.
NMDP had hoped the CMS “would issue a proposed rule to address underfunding issues for our nation’s bone marrow and cord blood transplant centers to support access to life-saving transplant for Medicare beneficiaries,” Chell said in a press release.
Although NMDP commends the CMS “for increasing reimbursement for transplant performed in the outpatient setting,” the proposed rules changes fail to address “reimbursement issues for bone marrow and cord blood transplants performed in a hospital setting,” he said.
Chell said his organization looks forward to working with the CMS “to make this update in its final rule, making sure the final rule brings us closer to paying for cell acquisition costs and adequately covering the cost of transplant for seniors for whom transplant is the only curative path.”
The CMS made key changes in its outpatient-transplant reimbursement policy in 2016, Chell said. One involved the way that healthcare provides reported transplant costs.
Because almost all transplants are done in hospitals, there is an urgent need for the CMS to address the issue of transplant-cost underpayment in hospitals, the NMDP said.
“We will continue to work on behalf of patients to eliminate access barriers to transplant,” Chell said. “We look forward to working with CMS to capture the true costs of transplants in the inpatient [hospital] setting, build a model for reimbursement that separates cell acquisition costs from the MS-DRG rate, and ultimately create an FY2018 final rule that aligns more with how CMS reimburses the acquisition costs of solid organs.”
NMDP manages what it says is the world’s largest and most diverse registry of potential marrow donors and donated cord blood. Its major goal is to connect patients with compatible donor matches for either marrow or umbilical cord blood transplants. It also educates healthcare professionals and conducts research through its Center for International Blood and Marrow Transplant Research program.
In addition, the nonprofit provides patient support, recruits potential donors for the registry and volunteers, and raises funds.
Seventy percent of patients needing transplants are unable to find a matched family donor, NMDP said. But there’s a 66 to 97 percent chance it can find a matched donor, depending on a person’s ethnic background, it added.
It pointed out that marrow-donor and cord-blood registries can continue to grow only if people sign up or donate their baby’s umbilical cord blood. The larger the registry, the more transplants that can occur, it said.
For more information on joining the Be The Match Registry, visit https://bethematch.org/about-us/how-we-help-patients/be-the-match-registry/ or call 1-800-MARROW-2.
