Spectrum heart transplants now in state hands

January 23, 2010
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State regulators are expected to decide the fate of Spectrum Health’s proposed heart and lung transplant program by March 2.

With a recommendation for approval from local health care planning agency Alliance for Health, the proposal now moves to Lansing for a decision from the Certificate of Need section of the Michigan Department of Community Health.

Spectrum is proposing to establish a heart and lung transplant program at the Meijer Heart Center, the busiest in the state with nearly 1,000 open heart surgeries per year. With CON approval, transplants would begin in 2011. The health system’s application indicates that it expects nine procedures the first year and 12 in each of the two subsequent years.

Bob Meeker, strategic planning manager for Spectrum Health, said the CON decision hinges on a point that first arose last summer: How many heart transplant programs does the state have?

CON standards limit that number to three. Transplants are already performed at the University of Michigan Hospital, Henry Ford Hospital and Michigan Children’s Hospital, all in southeastern Michigan.

But when a special Standards Advisory Committee reviewed the standards last year, it came across information that indicated that the Henry Ford and Michigan Children’s transplant programs were actually one program. That would leave the state with two programs and allow Spectrum to apply under the current three-program standard.

MDCH spokesman James McCurtis Jr. told the Business Journal that his department asked the attorney general’s office to review the point, but said the opinion is confidential.

But if the CON staff decides the programs must be counted separately, Spectrum’s plans could be derailed. Meeker said that if the CON were denied for that reason, “we would appeal.”

Dr. Bob Hooker, of West Michigan Cardiothoracic Surgeons and one of the main proponents of the program, served on the Standards Review Committee.

“By serendipity, we found out that Detroit Children’s is actually covered by Henry Ford. Just amazing,” said Hooker. “The whole purpose of getting the SAC was to look at having a transplant program on this side of the state.”

The committee considered but rejected the idea of splitting the state into two regions for consideration of heart transplant programs. It recommended no changes in the number of programs for Michigan.

Dr. Michael Dickinson, who oversees heart failure services at Spectrum, said currently two cardiologists, including himself, are qualified to care for heart transplant patients, and two more are in the process of being recruited.

Hooker said he was trained in transplant surgery at Stanford University, but his practice is seeking another transplant surgeon who would have United Network for Organ Sharing certification.

“We believe it’s consistent with the standards, and that Spectrum ought to be given the chance to bring in business,” Alliance for Health President Lody Zwarensteyn said.

Spectrum’s application indicated it would spend $550,000 for construction and renovation. During its first year of operation, the program would cost $3.78 million to run and would lose an estimated $2 million. Insurance companies don’t reimburse for heart transplants until the hospital has a track record, so Spectrum would pick up the tab for some of its first patients.

“Our dream is to be able to provide really good heart failure care, including transplant, for all of West Michigan,” Dickinson said.

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