This profile was last updated on . .
Is this you? Claim your profile.
Professor and Hematologist
Oregon Health & Science University
Direct Phone: (503) ***-****
3181 S.W. Sam Jackson Park Rd
Portland, Oregon 97239
Oregon Health & Science University is the state's only academic health and research university. As Portland's largest employer with approximately 14,000 employees, OHSU's size contributes to its ability to provide many services and community support not f... more
Principal Investigator, PhD Statistician
Fox Chase Temple BMT Program
MEDICAL ADVISORY BOARD Member
American Organ Transplant Association
Chair of the Committee
American Society for Blood and Marrow Transplantation
University of Notre Dame
"We have to have outlier clauses [with bundled payments], because our worst patients can use 10 to 100 times as many resources as the average patient," Dr. Gajewski explained.
"I may have a bone marrow transplant patient with congestive heart failure, liver dysfunction, or chronic obstructive pulmonary disease.
Caring for these comorbidities alone can cause as much resource use as the pathway for the transplant."
Because of these unknowns, institutions using bundled payments often have to negotiate the existence of outlier or stop-loss clauses in order to minimize risk.
Even for patients without higher comorbidity burdens, Dr. Gajewski said that stem cell and bone marrow transplants are becoming much more complex.
"The Centers for Medicare & Medicaid Services (CMS) would love to treat all hematologic malignancies the same and establish one fixed rate for transplant, but that's simply not possible," Dr. Gajewski said.
"If a patient is undergoing an autologous transplant, immunosuppression is not required and there is less risk for infection.
Resource use in this setting, then, is different than for matched sibling allogeneic transplant, which is different from resource use for a patient undergoing an unrelated donor transplant.
The list goes on."
Lymphoma Working Committee Study: LY08-01
Stem Cell Treatment for Leukemia Improved Transplant Technique Speeds Immune System Recovery
"Every other attempt to expand (cord blood) stem cells has basically failed,"
Our People | American Organ Transplant Association
Lake Shore Behavioral Health Inc
The TriZetto Group Inc
Clear Lam Packaging Inc
Chiron Technology Services Inc