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Are transfusions driven by reimbursement?

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When reimbursement for alternatives such as erythropoiesis-stimulating agents is available less blood is transfused.
asked May 16, 2012 in Other by Jan B. Wade (4,930 points)
retagged Jun 4, 2012 by LarryEitel

4 Answers

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They can be. Depending upon where you are the first 2 or 3 units per year per patient the hospital must "eat" - (or pass onto the patient ) since insurances including Medicare won't pay. However-- in a Dayton, OH news report April 11, 2012

For the blood alone, the hospital billed Anthem Blue Cross and Blue Shield in Ohio $17,829. The bulk of those submitted charges, $11,172, was for seven units of irradiated platelets. That works out to about $1,600 per unit of blood product.

Yet the insurance company in   Worland’s case, Anthem paid the hospital 32 percent of the billed charges, or just more than $5,700. Anthem has a lower negotiated rate for blood than other health insurers,

To hear the hospital - they lost money

Community Blood Center charges Miami Valley Hospital $571 per unit for the kind of irradiated platelets that Worland received. After accounting for its own costs, the hospital’s actual unit cost for such platelets is roughly $900 to $1,000, Shaw said.

Overall, Shaw said the hospital breaks even or ends up just slightly in the black on blood.
answered May 16, 2012 by pnutts (1,820 points)
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Not really-actually if you take into consideration the risks involved, transfusions can add to the cost of a hospital stay.  In the United States, procedures are reimbursed by how they are "coded".  All procedures are assigned a specific reimbursement code.  These "codes" are associated with contracted amounts or values that are reimbursed to the facilities that perform the procedures.  So if a patient receives a transfusion for a certain procedure, the cost of the transfusion is added to the cost of everything else that was necessary to perform that procedure.  So it "narrows" the amount the hospital makes on the procedure.  Also, if the patient acquires an infection from a hospital stay or has a reaction from a transfusion, their hospital stay can be longer and so increased length of stay adds to the cost of the procedure.  Typically, the first 3 units of blood for a patient are not reimburseable, so if this runs up to a couple of thousand dollars as shown by the figures spoken about in the previous answer - the procedure could cost the hospital money.  So then, hospitals don't order blood to get reimbursed, in fact, hospitals don't order blood.  The ordering of blood is done by the physicians.
answered May 16, 2012 by jlvarisco (2,070 points)
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Unintended Consequence for Dialysis Patients as Drug Rule Changes


A patient waiting for a kidney got dialysis. More dialysis patients are getting blood transfusions.

A shift last year by the federal government in how it pays for drugs to treat dialysis patients may have had an unintended and potentially dire consequence, according to new research: a significant jump in blood transfusions for patients who now may not be getting enough of the medications.

The findings are seen by some experts as a stark illustration of how the government’s reimbursement policies can drive the practice of medicine.

The policy shift was intended to save money and protect patient health by correcting what federal regulators saw as a misguided financial incentive for dialysis centers to overprescribe anti-anemiadrugs.

Previously, the government had paid dialysis centers for these drugs separately from the actual blood-cleansing treatments, effectively encouraging their overuse. That created health hazards, as well, because the high red blood counts produced by overuse of the drugs carry a heightened risk of heart attack and stroke.

So the federal Medicare program, which covers the treatment of life-threatening renal conditions, regardless of a patient’s age, changed its payment system to reimburse for overall care, bundling together the cost of treatment and drugs. For the dialysis centers, that instantly transformed the expensive drugs from a profit center to a drain on profits.


Read Article Here

answered May 17, 2012 by Jan B. Wade (4,930 points)
edited May 17, 2012 by Jan B. Wade
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When reimbursement for ESA's (erythropoiesis-stimulating agents) is cut off transfusion of major blood components increases.  Physicians many of whom would rather use alternative agents are forced to use an inferior and possibly deleterious product.


New Data Highlighting Possible Impact of ESA Reimbursement Policies on Patient Care, Nation’s Blood Supply, to Be Presented at American Society of Clinical Oncology (ASCO) Annual Meeting


Read Article Here


BRIDGEWATER, N.J., May 16 /PRNewswire/ — Data from three studies evaluating associations between lower mean baseline hemoglobin (Hb) levels and the rate of blood transfusions, as well as the possible effect of restrictions on reimbursement for erythropoiesis-stimulating agents (ESAs) in Medicare patients on the nation’s blood supply, will be presented at the American Society of Clinical Oncology (ASCO) Annual Meeting later this month. The meeting will take place in Chicago from May 30 to June 3, 2008.

Source: redOrbit (

answered May 17, 2012 by Jan B. Wade (4,930 points)
edited May 17, 2012 by Jan B. Wade
Lower the use of ESA and increase use of a product-blood in short supply- raise price of product-blood. Makes one wonder. According to comments made at an Anemia  and use of ESA conference  held in Europe the studies used to limit use of ESA's was flawed.

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