More than a year after Medicare told the Medical University of South Carolina it would stop paying for heart transplants because surgeons in Charleston weren't performing enough of them, volume is back up substantially.
The MUSC team has performed eight transplants so far this year. Twenty-one more patients are on a waiting list. Twenty-two have been done since the beginning of 2017, with every patient surviving the surgery.
MUSC is the only hospital in South Carolina that performs this procedure. More than half of all patients who require a heart transplant are covered by Medicare or other federal insurance. That caused a serious hangup last year when the federal health insurance program for seniors and people with disabilities announced it would halt all reimbursements for heart transplants at MUSC.
Research has shown that hospitals that perform more transplants also provide higher quality care.
MUSC earned back its Medicare certification on March 7. Hospital leaders told the MUSC Board of Trustees on Friday morning that the heart transplant program is officially rebuilt.
"We have one program in the state, which is us," said Dr. Thomas DiSalvo, chief of cardiology at MUSC. "Word has not been spread sufficiently throughout the state that patients with advanced heart failure need to be referred to selected centers, like us, early."
DiSalvo introduced board members to patient James Dewees, who had a heart transplant in late June.
Dewees went to the hospital for a heart catheter in mid-April, expecting to leave the same day. He knew he had congestive failure, and he was listed as a candidate for a heart transplant.
He was reluctant to have a major surgery, he told the board. But when he came in for the catheter, doctors determined the procedure was a necessity.
Dewees spent 65 days in the ICU before finally receiving a heart transplant on June 21.
"A lot of patients erode and melt during that process," DiSalvo said. "James was unbelievably strong."
Dewees, 52, was discharged 10 days after surgery.
MUSC continued offering heart transplants while Medicare payments were suspended because some patients were covered by private health insurance. U.S. News & World Report does not rank the MUSC heart transplant program among the top 50 in the country.
In South Carolina, 4.6 percent of the adult population reportedly has a heart disease, according to the Robert Wood Johnson Foundation.
There are about 2,200 heart transplants performed in the United States every year — only about a tenth of what is needed, DiSalvo said.
An aggressive recruiting effort has brought eight heart failure transplant cardiologists to MUSC over two years. There are now 11 in the state. DiSalvo told the board he thinks the team can now compete with any program in the country. The hospital will need to continue to focus on research and education to better its standing. Part of that will include establishing a heart failure fellowship.
He said the goal should be nothing less than "eradicating the scourge of heart failure."
At the same meeting, the board voted in Charles Schulze as chairman and James Lemon as vice chairman. Officers on the MUSC Board of Trustees serve two-year terms. Schulze, a retired CPA, has been on the board since 2002; Lemon, a dentist, has been serving since 2014. They replace Dr. Donald Johnson, the current chair, and William Bingham, vice chairman. All board members are appointed by the General Assembly.