The Partnership for Quality Measurement (PQM) endorsed two measures of early organ-donation activity, giving U.S. organ procurement organizations (OPOs) a way to compare referrals and donation conversations while federal oversight continues to use outcome rates.
The Association of Organ Procurement Organizations (AOPO) announced the endorsement Oct. 27. PQM’s Spring 2026 cycle identifies Referral Rate as CBE ID 5601 and Approach Rate as CBE ID 5602. The entries give August as the initial endorsement month and classify each as a process measure.
For Referral Rate, PQM compares the yearly volume of hospital referrals involving ventilated patients ages 0 to 80 with 100 potential donor deaths in an OPO’s donation service area. The calculation uses OPO referral records and national death statistics.
Approach Rate measures the number of referrals involving ventilated patients ages 0 to 80 for which an OPO held a donation conversation, per 100 such referrals in its service area during a calendar year. Its denominator is made up of referrals involving ventilated patients ages 0 to 80. Conversations can take place face-to-face, by phone or through telehealth.
OPOs are nonprofit organizations that evaluate potential deceased donors and procure organs for transplantation. PQM says the referral measure can help OPOs and hospitals compare practices and timing and identify opportunities for improvement. It cautions that over-referrals can consume OPO resources; for Approach Rate, 100% is not the goal, and benchmarks have not been set.
Both measures concern activity before an OPO obtains authorization or recovers organs. The Centers for Medicare & Medicaid Services (CMS) currently uses donation and transplant outcome rates to tier OPOs and determine recertification. PQM’s records document the endorsements but do not say CMS has incorporated the measures into federal requirements.
AOPO says the broader project began with Econometrica, Inc., and 53 OPOs. PQM marked two related submissions, Authorization Rate and Donation Rate, as not endorsed because the review reached no consensus.
“Outcome measures tell us what happened. Process measures can help us understand why it happened,” said Dr. Jean O’Connor, Econometrica’s Health Practice Area Director.
CMS has said it expects to issue a further rule on OPO Conditions for Coverage in late 2026. Current OPO agreements expire in January 2027.
