UA Lung Transplant Docs Help Banner – UMC Tucson Gain ‘Institute of Excellence’ Status with Aetna

Image of lungs overlayed with 'YES!' with Aetna Institutes of Quality SealBanner – University Medical Center Tucson and the University of Arizona pulmonary division can add another kudo to their list of accreditations and accolades with Aetna Inc.’s designation of the hospital as an “Institutes of Excellence™ Transplant Facility” for lung transplantation.

The hospital previously was designated as such for the following transplant procedures, according to Aetna’s website:

Adult:

 • Bone Marrow  • Transplant - Allo
 • Bone Marrow Transplant - Auto
 • Kidney
 • Pancreas
NHLBI illustration of lung transplant process • Pancreas after Kidney
 • Simultaneous Pancreas Kidney

Pediatric:

 • Bone Marrow Transplant - Allo
 • Bone Marrow Transplant - Auto

At right, an illustration of the lung transplantation process: In figure A, the airway and blood vessels between a recipient’s diseased right lung and heart are cut. The inset image shows location of the lungs and heart in the body. In figure B, a healthy donor lung is stitched to the recipient’s blood vessels and airway. (Source: Wikipedia/NHLBI)

The Hartford, Conn.-based health insurance company added lung transplants to that list via a letter to Banner – UMC Transplant Services in mid-November. The designation was effective Dec. 1, 2017.

“What a way to end the week. This is impressive to obtain a ‘Center of Excellence’ status in such a short time,” Deborah Maurer, RN, advanced organ and transplant management administrator at Banner – University Medicine, said at the time—referring to the hospital regaining CMS certification for lung transplants only a year earlier.

“I would encourage all to celebrate as this is what teamwork is all about! I’m looking forward to making this happen with Optum in 2018,” she added. Optum is a health information technology and services company that is part of another national health insurance firm, UnitedHealth Group.

Maurer noted that the designation would not have been possible without cooperation between surgery, pulmonology and transplant physicians at both Banner – UMC Tucson (BUMCT) and Banner – UMC Phoenix (BUMCP), which refers lung transplant patients to BUMCT for the service.

Drs. Scott Lick, Steve Knoper, Josh Malo and Rajeev SaggarKey players on the lung transplant team, include Scott Lick, MD, a UA professor of surgery and the surgical director of the lung transplant program at BUMCT; transplant pulmonologist and program medical director Steve Knoper, MD, transplant pulmonologist Joshua Malo, MD, and Rajeev Saggar, MD, UA clinical associate professor, executive director, BUMCP Advanced Lung Disease Care, and chair, clinical medicine, Banner – University Medical Group. Drs. Knoper and Malo are on faculty as assistant professors of pulmonary and critical care with the UA Division of Pulmonary, Allergy, Critical Care and Sleep Medicine (PACCS), which is one of 14 divisions of the UA Department of Medicine—the largest department within the UA College of Medicine – Tucson.

Drs. Knoper and Malo said, "We are thrilled to have the opportunity to expand our transplant services through Aetna's 'Institutes of Excellence' recognition. This landmark for our lung transplant program represents the combined efforts of a large team to provide the best care to individuals suffering from advanced lung diseases."

“I’m so grateful that the IOEOC (Aetna’s Institutes of Excellence Oversight Committee) was able to approve the organ as IOE so quickly,” wrote Jynelle Mikula, Aetna Network Manager for National Transplant Contracting, in her email reply.

“More great news!” said Tom Dickson, CEO of Banner – UMC Tucson and South. “Congratulation to our program!” 

Sairam Parthasarathy, MD, PACCS interim chief, said, “This is a remarkable accomplishment that provides high quality patient care and engenders research and training in a crucial area here. Kudos to the lung transplant team.” Dr. Parthasarathy also is a professor of medicine and director of both the BUMCT Center for Sleep Disorders and UA Center for Sleep and Circadian Sciences.

The Aetna National Medical Excellence Program coordinates care and provides access to covered transplant treatment through its national Institutes of Excellence™ network. The network is made up of selected hospitals that have met extensive quality and cost-effectiveness criteria to participate as an Institutes of Excellence Transplant Facility for solid organ transplants and bone marrow transplants. These facilities have been contracted on a transplant-specific basis and facilities are considered participating only for the transplant type listed in this directory.

To be considered in-network for coverage for transplant-related services, including evaluation, transplant, and follow-up care, patients and physicians must utilize an Institutes of Excellence participating facility that has been specifically contracted by Aetna for the transplant type. Services must be pre-authorized with Aetna for coverage to be effective. Any facility that is not specified as an Institutes of Excellence network facility is considered non-participating or non-preferred for transplant-related services, even if they are considered participating for other types of services.

Learn more at either of the following links:

Monica Kraft, MD, professor and chair, UA Department of Medicine, deputy director, UA Health Sciences Asthma and Airway Research Center, and the Robert and Irene Flinn Endowed Chair of Medicine, noted, "I’m incredibly proud of our lung transplant team. Through very effective collaboration between Tucson and Phoenix, these providers and staff—this team—has really knocked it out of the park. And they’ve done it in such a short time. I’m just over the moon about it. "

—David Mogollón

ALSO SEE:
“Pulmonary Docs Thrilled with CMS Certification for Lung Transplant Program” | Posted Oct. 21, 2016

Release Date: 
01/19/2018 - 9:15am