As the federal government prepares to take action against underperforming transplant centers, new data released this month show no improvement in the number of programs that fail to meet Medicare survival standards.
Eleven of the 234 federally funded liver, heart and lung programs had one-year survival rates that fell below the benchmarks established by the U.S. Centers for Medicare and Medicaid Services, according to the latest data from the Scientific Registry of Transplant Recipients. The data cover different 2 1/2 -year periods from 2002 to 2005, depending on the organ.
The same number of centers had subpar survival rates in the registry's January report, but some programs have been added and others dropped since then.
The Medicare agency, which funds most of the nation's transplant centers, requires programs to achieve a specific survival rate to be certified initially for funding. Medicare also requires transplant programs to perform a minimum number of operations to ensure competency. The benchmarks vary by organ, and there are none for kidney transplants.
Last month, The Times reported that nearly 50, or about one in five, federally funded transplant centers did not meet at least one of those standards.
After questions from The Times earlier this year, the Medicare agency sent letters to every certified transplant center requesting information on performance, staffing and changes that could affect patients. Officials have completed their review of the responses and are finalizing a list of underperforming centers, said Dr. Barry Straube, Medicare's chief medical officer, in a statement.
The agency "will then take appropriate action to ensure compliance" with Medicare standards, he said, up to and including pulling federal funding. The agency expects to publicly announce its plans in the next few weeks.
The Times reported earlier this month that, based on the new data, the liver transplant program at USC University Hospital had logged one of the highest death rates in the country. Less than 76% of patients who received new livers at USC from January 2003 to June 2005 survived at least a year, according to the Scientific Registry of Transplant Recipients. The federal benchmark is 77%.
Among other centers that fell short of Medicare's standards were the lung and liver transplant programs at Johns Hopkins Hospital in Baltimore.
