CLEVELAND, Ohio — As the Cleveland Clinic expands in big ways in places like Abu Dhabi and Las Vegas, it’s also expanding in small ways closer to home: A satellite kidney transplant program that recently opened its second location in Indianapolis.
The Clinic’s kidney transplant program aims “to provide the best possible care to as many patients as possible,” said Dr. Eric Klein, chairman of the Clinic’s Glickman Urological and Kidney Institute.
But the expansion also is a “pure business” decision, Klein said.
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Populations around Cleveland are falling, and the Clinic is seeing insurance and government reimbursements fall. So it plans to increase patient volumes by taking its kidney transplant program to hospitals that are a good fit: similar health care cultures, patient populations that need kidney transplants, and enough patients to make the programs financially successful for the Clinic and its partners.
“One of the ways we can continue to grow at the pace we want to grow — and continue to do the things we want to do — is to drive patient volume,” Klein said. That means “we have to cast our net wide to get patients into our system. And this is another way of doing that.”
The Clinic agreed to help start and to staff the St. Vincent Indianapolis program about a year ago, said Mary Ann Palumbi, executive director of transplant services for the faith-based hospital.
“It’s basically what we would term a management agreement,” Palumbi said. Under the agreement, “the Clinic will support this program through the presence of qualified renal and pancreas transplant surgeons.”
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The financial portion of the agreement between the Clinic an St. Vincent is confidential, Klein said.
Under the Clinic’s first satellite kidney transplant program at Charleston Area Medical Center, it provided two surgeons who worked with a staff of four certified clinical transplant coordinators, a dietitian, a social worker and several attending nephrologists, according to the medical center’s Web site.
The Charleston, W.Va., program has performed more than 650 kidney transplants since beginning the program with the Clinic in 1987. Charleston Area Medical Center has a kidney graft survival rate of 94 percent one year after transplantation, compared to the national average of 88 percent, according to the Web site.
Dr. Bashir Sankari, who started the Charleston program 16 years ago, has moved to the St. Vincent program as surgical director. The Clinic is looking for someone to replace Sankari in Charleston, Klein said.
Another Clinic doctor, Dr. Alvin Wee, will staff the Indianapolis satellite program. Both Sankari and Wee are kidney and pancreas transplant surgeons. They will be joined by Dr. Mahendra Govani of St. Vincent, who is medical director, according to the Indianapolis hospital.
Palumbi and Sankari sat on the board of the same organ procurement organization for more than a dozen years. So when Palumbi found out that Sankari was moving to St. Vincent, she moved there herself.
“I thought I could start one more program in my life,” said Palumbi, who helped start two other organ transplant programs in the Pittsburgh area and also was attracted to the Indianapolis program because of its growth potential.
St. Vincent Indianapolis, which has been doing heart transplants for 20 years, has done three kidney transplants under the Clinic program since starting to screen patients in December, she said. “It’s moving very quickly,” Palumbi said.
The Clinic has evaluated several kidney transplant partnerships since starting the first one in Charleston, Klein said. The Clinic picked St. Vincent Indianapolis because it was a good fit with the Clinic’s culture and mission.
“It has to be with an institution that shares our commitment to patient-first care and has the kind of patient population that would benefit from the services that we can offer,” Klein said. “And it has to work out financially for both sides.”
Palumbi concedes that health care has become a business. “But there are ways we look at the patient first,” she said.
[Front page image of kidney transplant unit from Skeddy in NYC on Flickr]
