28,000 organs go unrecovered every year,
leading to loss of life and increased Medicare costs
Organize
could be saved for taxpayers in just 10 years through reform
are currently on the waiting list for a lifesaving organ
die every day in need of a transplant
The Problem
The organ donation system is grossly inefficient, failing to recover and transplant as many as 28,000 lifesaving organs every year.
The problem is a system of unaccountable, government monopoly contractors, called organ procurement organizations (OPOs), with a history of underperformance, obstructionism, and fraud, waste and abuse.
As the New York Times editorial board wrote: “an astounding lack of accountability and oversight in the nation’s creaking, monopolistic organ transplant system is allowing hundreds of thousands of potential organ donations to fall through the cracks."
OPO failures also disproportionately harm patients of color. See here for a new report supported by Schmidt Futures and Arnold Ventures.
Solution
Congress: investigate the government monopoly contractors in charge of organ donation
HHS: Hold OPOs accountable by swiftly enforcing newly-finalized metrics
HHS: should reform its governance and oversight structures for OPOs, including through the creation of a dedicated Office of Organ Policy
The Administration is moving on the issue but it’s critical not to lose momentum during COVID- 19, especially since COVID-19 puts patients at additional risk via dialysis centers and added risk of organ failure
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EXECUTIVE BRANCH
July 2019: Executive Order on Advancing American Kidney Health, highlighting the need for OPO reform
December 2019: HHS proposed new OPO regulations, finding more than half of all OPOs to be out of compliance. Secretary Azar’s official remarks: “We’re going to stop looking the other way while lives are lost and hold OPOs accountable.”
November 2020: HHS finalized new OPO metrics, projected to save 7,300 additional lives every year once implemented.
Areas in the red failing outcome measures proposed by HHS in 2019
“Recent reports suggest that OPOs, which are tasked with acquiring and distributing organs for donation, are systemically underperforming, resulting in long wait lists and thousands of deaths each year.”
Senators Elizabeth Warren and Richard Blumenthal
— Name, Title
BIPARTISAN SUPPORT ON THE HILL INCLUDES
Oversight letters:
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Senators Grassley, Wyden, Young and Cardin to the United Network for Organ Sharing (UNOS)
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Rep. Katie Porter to HHS
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Senators Grassley and Young to Office of the Inspector General
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25 bipartisan Representatives calling for OPO accountability
Statements of Support:
Op-eds:
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Rep. Karen Bass, Chair of the Congressional Black Caucus, in The Hill
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Senator Todd Young in The Hill
Reports:
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House Appropriations Committee: “The Committee supports... efforts to establish objective outcome measures for Organ Procurement Organizations (OPO) as well as efforts to decertify underperforming OPOs at the conclusion of the current contract cycles.”
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Congressional Research Service: “Under the proposed rule, based on most recent performance data, many OPOs would not meet the measures required to be recertified.”
Stakeholder Reports:
“We’re going to stop looking the other way while lives are lost and hold OPOs accountable.”
— Name, Title