Spectrum heart site revived

August 31, 2009
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A heart transplant program at Spectrum Health is more likely to siphon local adult patients from two Southeast Michigan centers as the number of cases in the state has remained steady since 2000, a health policy expert said last week.

“There will in all likelihood be no more people who have heart transplants in the state because of a West Michigan facility,” said Dennis McCafferty, director of health policy for the Economic Alliance of Michigan.

“The issue is not so much access; it is availability. The right donors matching the right recipients has been pretty consistent for the last 10 years. Providing another place where the procedure is performed won’t impact the number of donors. It’s not going to change significantly the numbers.”

The Economic Alliance, Blue Cross Blue Shield of Michigan and the University of Michigan Health System last fall opposed Spectrum Health’s request for the state Certificate of Need Commission to review the number of programs, as well as other standards, for heart, heart/lung and liver transplants. But faced with an avalanche of support for Spectrum from West Michigan business, political and health care leaders, the commission appointed a Standards Advisory Committee, which began meeting in the spring.

As was reported in an exclusive GRBJ.com breaking news report last week, as the committee’s review progressed, it was brought to the attention of the CON staff at the Michigan Department of Community Health that the state actually has two heart transplant programs, not three, as virtually everyone had assumed, McCafferty said.

It turned out that the adult heart transplant program at Henry Ford Hospital and the pediatric transplant program at Children’s Hospital of Michigan were actually approved in the 1990s as a single program, said Spectrum Health Senior Vice President John Mosley. Both adult and pediatric heart transplants also are performed at the University of Michigan.

The glitch means that Spectrum Health is able to apply for a Certificate of Need to establish a heart transplant program without a change in the state standards. Spectrum filed a letter of intent last Monday, the first step in the CON process, Mosley said.

McCafferty blamed the misunderstanding on “a loss of institutional memory.”

He said that after a recent Heart, Lung and Liver Standards Advisory Committee meeting, a member of the audience produced a two-decade-old document that showed that the programs at Henry Ford and at Children’s Hospital were approved under a single Certificate of Need. By the next meeting, the MDCH’s CON staff confirmed the situation and was “a little embarrassed,” McCafferty said.

“It’s clearly an indication that not a lot has happened in this area of medicine over the last 20 years or so,” he said. In light of the recent information, the Economic Alliance won’t oppose Spectrum’s bid, he added.

According to the MDCH, Henry Ford performed 10 heart transplants and the University of Michigan performed 33 in 2007, the latest figures available.

McCafferty said too many transplant centers would have a negative impact on quality and costs.

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