Organize statement on November 20, 2020 OPO Rule
Organize, a patient advocacy non-profit organization focused on increasing the supply of lifesaving organs for transplant, supports long-overdue reforms to organ procurement organizations (OPOs) - the government monopoly contractors that run the organ donation system. The Department of Health and Human Services (HHS) estimates these reforms will save an additional 5,600 lives every year.
Peer-reviewed research shows OPOs are grossly inefficient, failing to recover as many as 28,000 lifesaving organs for transplantation every year. Historically, this problem has been masked by a poorly-written and unenforceable regulation that allowed OPOs to self-interpret and self-report their own performance data, a system highly susceptible to gaming.
While OPO performance is lacking across the board - data released by HHS shows 34 OPOs are failing against new performance standards - research shows that it is even worse for patients of color. Minority populations are more likely to need lifesaving organ transplants, and yet are far less likely to receive them. In addition to other contributors, this results from differential treatment patients of color receive from OPOs at every step in the donation process.
The Administration’s new regulation creates an objective framework by which HHS can evaluate OPO performance and, importantly, to replace failing OPOs with higher performers. This will allow HHS - for the first time - to ensure that all patients are served by high-performing OPOs, regardless of their ethnicity or geography.
OPO reform also brings enormous cost savings to the American taxpayer. Because every kidney transplant saves Medicare as much as $250,000 per patient to the federal dialysis program, OPO reform, at scale, can save taxpayers as much as $40 billion over 10 years.
Even while America is politically divided, OPO reform has enjoyed almost uniquely bipartisan support. These efforts began under the Obama-Biden Administration and continued into the Trump Administration, with Congressional champions on both sides of the aisle.
It is troubling, however, that the rule states that failing OPOs will not be decertified until 2026. HHS has shown, with objective data, that many of its contractors are failing, and that holding them to higher standards will save as many as 5,600 more lives every year; to wait six years to do so, by extension, is to consign more than 30,000 Americans to death. A new report from the Bridgespan Group outlines a roadmap for increasing organ availability through the decertification process, and the COVID-19 pandemic - which raises the risk of organ failure - only increases the urgency to do so.
We encourage the Biden-Harris Administration to work urgently and quickly to enforce these new measures before the 2026 cycle, and for Congress to continue their aggressive and much-needed oversight efforts in patients’ interests, consistent with those led by the Senate Finance Committee as well as Representatives Katie Porter and Karen Bass. Organ transplant waiting list patients have suffered for far too long.