CMS suggests implementing compulsory organ transplant model

The Centers for Medicare and Medicaid Services (CMS) is proposing a new mandatory model, the Increasing Organ Transplant Access (IOTA) Model, aimed at improving access for kidney transplant patients and helping hospitals increase the quality of the transplants they perform.

The goal of the IOTA Model is to increase access to kidney transplants for all people living with end-stage renal disease (ESRD) and reduce disparities among those undergoing the transplant process. Participating transplant hospitals would be measured by increases in the number of transplants performed, organ acceptance rates, and post-transplant outcomes.

Out of the 257 transplant hospitals in the country, an estimated 90 would be required to participate in the proposed six-year model beginning January 1, 2025. The model would offer additional performance incentives to improve equity in the transplant process, requiring hospitals to establish health equity plans to address gaps in access among populations in their communities.

The proposed model aligns with the Biden administration’s efforts to improve collaborative efforts between CMS and the Health Resources and Services Administration (HRSA) to increase organ donation and improve clinical outcomes. HRSA has also launched the OPTN Modernization Initiative to strengthen accountability and performance in the organ transplant system.

Despite the scarcity of organs, about 30% of donor kidneys go unused annually, highlighting gaps in procurement, distribution, and utilization. The IOTA Model aims to address these issues and improve the overall transplant system for people with ESRD.