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Likely wants to avoid saying ‘We’re doing this for black patients,’ but effect is same

 

(Image courtesy Pixabay)

By Kate Anderson

The Department of Health and Human Services (HHS) is looking to push equity requirements on hospitals providing kidney transplants, according to a recent proposal.

The proposal, announced May 8, will help President Joe Biden’s administration’s plan to address “racial bias” when it came to wait times and “profiteering and inequity” by transplant hospitals, Secretary Xavier Becerra said in the press release. HHS’ proposal would incentivize hospitals to prioritize low-income patients via a point system and create “health equity” plans to address patient gaps.

“The organ transplant industry, like every other part of society, is not immune to racial inequities,” Becerra said in the press release. “Black Americans disproportionately struggle with life-threatening kidney disease, yet they receive a smaller percentage of kidney transplants. The Biden-Harris Administration is taking concrete steps to remove racial bias when calculating wait times and rooting out profiteering and inequity in the transplant process.”

If implemented, participating hospitals would be scored annually based on the total number of transplants, acceptance rates, and post-transplant success, but a large portion of those points, 60 out of 100, are based on the number the hospital performed compared to the government target, which places extra weight on low-income patients, according to the proposal.

“Each kidney transplant that is furnished to a patient who meets the low-income definition would be multiplied by 1.2, thus counting that transplant as 1.2 instead of 1,” the proposal reads. “The resulting count of the overall number of kidney transplants performed during the PY [performance year], after the health equity performance adjustment is applied, would then be compared to the transplant target.”

The rule would also require transplant hospitals to adhere to “additional performance incentives … to improve equity in the transplant process,” according to the press release. One of the requirements would force hospitals to have a health equity plan so they can see “gaps in access among populations in their communities.”

“For example, participants could establish programs to educate and support potential living donors from underserved communities or to provide transportation assistance to patients on a waitlist,” the press release reads. “Participating transplant hospitals would also have the flexibility to address barriers related to social drivers of health, such as food insecurity and out-of-pocket prescription drug costs.”

Dr. Stanley Goldfarb, a kidney specialist and founder of Do No Harm, told the Washington Free Beacon that the administration likely wants to avoid saying “We’re doing this for black patients,” but that the proposal has the same effect.

“And so I think what they’ve just decided is, ‘We’ll just give an incentive to the hospitals to do this and let them figure out how to do this,’” Goldfarb said. “But I don’t know that there’s a real system in place to allow that. So either you’re going to have a system that ends up being purely on the basis of race, or it’s going to be a system that fails totally.”

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