Weekly Business Insights 08/06/2024
Patient Blood Management and Its Role in Supporting Blood Supply. United States blood pricing: A cross-sectional analysis of charges and reimbursement at 200 US hospitals. Improving the fragile US supply of blood.
Patient Blood Management and Its Role in Supporting Blood Supply
A comprehensive blood management program not only focuses on optimal blood product utilization but also has a component for reducing blood product wastage. Although a fraction of blood product wastage is inevitable, minimizing avoidable wastage can play a crucial role in blood product supply conservation. With an average rate of 1 to5% blood product wastage, a few hundred thousand blood products are discarded annually in the US. A multidisciplinary approach, including implementing effective inventory management for tracking and storing blood products and communication with ordering providers, can be used to minimize blood product wastage. Heitmiller et al used an interdisciplinary team and the Lean Six Sigma methodology. They reduced overall RBC wastage by approximately 50% (4.4% to less than 2%). A recent study by Levin et al showed that even a low-cost initiative such as physician-to-physician communication could significantly reduce blood product wastage. In adwindling donor supply setting, there is a greater need to promote PBM as a standard of care.
Infrastructure Concerns (US): For a successful blood center, achieving 100% voluntary, non-remunerated blood donors (VNRBD)are considered a landmark for the available resources. However, monetary allocations for rewards and the availability of modern infrastructure play avital role in achieving the above status. Contrarily, blood donor programs are often perceived to be inexpensive to run, and they receive lower priority in funds allocations in governmental-run blood centers and more so in LMICs.
This fund insufficiency affects donor recalls, the operation of mobile donor vehicles, and the maintenance of vehicles. While much work has been done globally on blood availability, blood and transfusion safety, and appropriate use of blood and blood components, each country’s approach to funding the blood supply and provision of transfusion needs to be standardized and is highly variable. Funding varies among countries, with some countries with no specific mechanism and others using cost recovery.
Patient Blood Management and Its Role in Supporting Blood Supply - PMC (nih.gov)
United States blood pricing: A cross-sectional analysis of charges and reimbursement at 200 US hospitals
Transfusion remains one of the most common procedures in healthcare; however, the exact acquisition cost and charges are unknown. While the average acquisition cost of a Red Blood Cell(RBC) unit is accepted to be approximately $200, the labor-based or associated costs of transfusion are more difficult to quantify. With recent United States(US) federal legislation, health systems are required to release charge masters for all billable procedures and negotiated rates by the payor, resulting in large amounts of data available for healthcare providers and patients, including transfusion-related data.3 Blood acquisition is the largest expense for a hospital blood bank
Our findings demonstrate significantly larger charges than the purchase prices for blood products with negotiated reimbursements much lower than charges. Charges were significantly higher in proprietary or privately owned hospitals. While the RBC acquisition cost is $200 per unit fora hospital blood bank, the subsequent charge for the blood is $600 and the charge for the transfusion procedure is $2000. Of note, reimbursement by private insurers was the highest. The three private insurers had higher reimbursements compared to reported CMS-negotiated rates.
Improving the fragile US supply of blood
In spite of impressive steps to reduce the need for blood through the use of minimally invasive surgeries, the amount of blood collected through donations had been falling for decades. And in Seattle, a local blood bank, Bloodworks Northwest, tells us that stocks were nearly depleted for the first time in its 75-year history—even in the absence of a crisis.
Every year in the United states, nearly 21million blood components (red blood cells, platelets, and plasma) aretransfused,6extending and improving the lives of more than four million Americans.Blood is used for a wide spectrum of healthcare services: surgery, cancer, trauma, maternal hemorrhage, organtransplantation, and various other acute and chronic health conditions allrequire blood transfusions .
If there is good news in the story, it’s that the demand for blood has steadily decreased over the past decade. From 2000 to 2020, the transfusion rate per capita in the United States has decreased by 2 percent per yearThatdecline follows revisions to transfusion guidelines from professional medical societies to reduce the overall number of blood units used in various procedures.