Houston Matters

Analysis of Baylor St. Luke’s Losing Federal Funding for Heart Transplant Program

Less cardiologists might refer their patients to the hospital, which nonetheless says it is communicating with the Centers for Medicare & Medicaid Services

The end of federal funding for Baylor St. Luke’s Medical Center’s heart transplant program could have several negative consequences, although the hospital says it is communicating with the Centers for Medicare & Medicaid Services (CMS) to look at “options.”

Back in June, CMS notified the hospital it would no longer approve Medicare and Medicaid reimbursement for heart transplant services starting August 17. That means Baylor St. Luke’s won’t be able to bill the government for such services.

Mike Hixenbaugh, a Houston Chronicle investigative reporter who has written about this topic, told Houston Matters Friday it is possible private medical insurance companies would follow suit.

Hixenbaugh also thinks the impact of the end of federal funding can mean less patients are referred to Baylor St. Luke’s. “Cardiologists send patients to this hospital from around the region, and around the state, and even from outside of the state, because of the full suite of services offered for patients who are suffering from heart failure,” the reporter noted “and, if there’s some question as to whether or not that patient will be able to get a heart transplant, doctors might not refer their patients there.”

The end of federal funding for Baylor St. Luke’s Medical Center’s heart transplant program could have several negative consequences, although the hospital says it is communicating with the Centers for Medicare & Medicaid Services to look at “options.”

For Hixenbaugh, what has happened is “striking” because this is the hospital where Dr. Denton Cooley made historic strides in the field of heart transplants in the 1960s. “After they formally established the heart transplant program in 1982, since then, they’ve done more heart transplants than most other hospitals in the country, only a few have done more, and it’s really become key to this hospital’s reputation and legacy.”

Hixenbaugh underlined that CMS has determined that Houston has enough capacity to take care of patients from the region who need a heart transplant.

Both Methodist and Memorial Hermann have heart transplant programs and, through the middle of the year, both hospitals had done about 28 heart transplants. “If patients need a (heart) transplant in Houston, there are places to go,” Hixenbaugh said.

Possibility of appeal

The reporter also explained there is a process by which Baylor St. Luke’s can appeal the decision and it has until September 14 to do that.

Baylor St. Luke’s Medical Center said in a statement its heart transplant program “remains active and continues to ensure all of the critically ill patients continue to receive the care they need” and added the hospital “is continuing to communicate with CMS about possible options.”

The statement noted that the hospital has advised all of its Medicare and Medicaid patients on the heart transplant wait list of their options and “many of them have chosen to continue their care at Baylor St. Luke’s with the physicians and staff they have come to know.”

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