HRSA seeking to reform organ transplant system
The agency wants to modernize matching technology and reduce inequities in the waitlist process.
Photo: serts/Getty Images
The Health Resources and Services Administration is leveraging new legal authority proposed in the President Biden's Fiscal Year 2024 budget, issuing requests for proposals in advance of executing multiple different contract awards meant to increase competition as part of its Organ Procurement and Transplantation Network (OPTN) Modernization Initiative.
HRSA is also taking steps to modernize organ matching technology – while increasing transparency – by issuing new data reporting requirements geared to better address pre-waitlist and organ procurement practices.
This, the agency said, will help address inequities in the transplant waitlist process by reducing racial and ethnic variation both in patient referrals and in organ procurement.
"For the more than 100,000 patients on the organ waitlist and their families, the time for reform is now," said HRSA Administrator Carole Johnson. "The steps we at HRSA are taking today demonstrate our commitment to a more fair, well-managed, and high functioning organ transplant system in this country."
WHAT'S THE IMPACT?
In March 2023, HRSA launched its OPTN Modernization Initiative to strengthen accountability and the performance of the nation's organ transplant system by focusing on improving the OPTN's governance, technology and operations.
Until that time, all functions of the OPTN were managed by a single vendor, rather than awarding multiple contracts based on technical expertise in areas like IT or operations. But new legislation reformed the decades-old statute, enabling HRSA to change the system and make multiple different contract awards to access a variety of vendors.
The legislation also gives HRSA the authority to implement its goal of creating an OPTN Board of Directors independent from other OPTN contractors to strengthen accountability and oversight. In addition, the new law eliminated the arbitrary appropriation cap to fund the work.
As part of the Modernization Initiative, HRSA conducted market research, reviewed responses to a HRSA request for information seeking public input on reforms, hosted two industry days with over 300 participants each, and engaged in more than 800 conversations with patients and community members.
Based on that, the agency is issuing a solicitation to support an independent OPTN Board of Directors, with a special election to seat the Board within six months of the contract award. This will break up the decades-old practice of the same Board of Directors overseeing the vendor that received the only OPTN contract and the OPTN itself. By separating the board and implementing new requirements to ensure its independence, the agency hopes to establish independent governance and ensure stronger conflict of interest requirements.
HRSA is also releasing multi-vendor solicitations for the OPTN informed by its market research. This will involve developing processes for monitoring and measuring patient safety, OPTN member performance, and compliance across all OPTN membership types and phases of the organ donation. It will also update and improve the IT infrastructure.
Further actions include beginning the transition to a modernized matching system that utilizes leading IT standards, and addressing "pre-waitlist" inequities in the organ waitlist process.
THE LARGER TREND
The scope and scale of HRSA's awards under these new solicitations is contingent on final Fiscal Year 2024 appropriations. HRSA's Fiscal Year 2024 Budget proposes a $36 million increase over FY 2023 to support the modernization efforts.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
