The Blood Matters Blog ·

Why OBI Supports Greater Blood Transfusion Access for Hospice Patients

Senate Bill 2186, the Improving Access to Transfusion Care for Hospice Patients Act, would allow for end-of-life patients to more easily receive at-home blood transfusions and, ultimately, more compassionate health care.


Last summer, a bi-partisan bill was reintroduced in the U.S. Senate that has the potential to greatly improve the quality of life for patients in hospice care.

The bill, the Improving Access to Transfusion Care for Hospice Patients Act (S.2186), would require the Center for Medicare and Medicaid Innovation to test allowing blood transfusions to be paid separately from the Medicare hospice all-inclusive per diem payment.

“The stress of caring for a loved one at the end of life is difficult enough. Reducing any burden on the patient and their family, for them to be able to focus on the things that matter, is priceless,” said former Our Blood Institute Chief Medical Officer Dr. Tina Ipe. “Blood transfusions in outpatient settings, including patient homes, is a game changer, but they are not readily accessible to transfusion-dependent patients outside a clinical trial currently in the United States.”


Making Hospice Transfusion Access a Reality

New research from OU Health Stephenson Cancer Center supports the blood transfusion carve-out, finding that hospice patients who experienced bleeding, breathlessness and profound fatigue showed significant improvement following blood transfusions. The study also found that symptom-triggered transfusions minimized the complexity of transfusion support and maximized patient-centered care.

Currently, the lack of appropriate reimbursement for blood transfusions prevents many hospices from providing quality of life-enhancing blood to hospice beneficiaries. Consequently, terminal patients who require transfusions to alleviate their symptoms and their families are faced with an impossible choice: receive at-home care through hospice services without the benefit of blood transfusions or receive symptom-relieving transfusions in-hospital.

“The lack of reimbursement for specialized care, including the provision of blood in outpatient settings, in the United States effectively ensures that patients do not receive the care they need,” Ipe said. “The pandemic taught those of us in the health care industry that patients prefer receiving care outside the hospital. However, the reimbursement model restricts most specialists from providing care in settings that patients prefer, namely physician offices or the comfort of their own home.”

Despite concerns over the cost-effectiveness of expanding transfusion access to end-of-life patients, there is ample evidence to suggest that the current Medicare model results in higher costs to the health care system. Delayed enrollment in hospice has been shown to lead to a greater number of emergency room visits and hospital admissions in the last 30 days of life, for instance.

Our Blood Institute firmly supports the passing of S.2186 and stands alongside national organizations like the Association for the Advancement of Blood & Biotherapies (AABB) and America’s Blood Centers (ABC). To ensure this critically important legislation is voted on and ratified, we encourage you to contact your senators.

Congressional Contact Information

  • Arkansas

    Sen. John Boozman
    Phone: (202) 224-4843
    555 Dirksen Senate Office Building
    Washington DC 20510

    Sen. Tom Cotton
    Phone: (202) 224-2353
    326 Russell Senate Office Building
    Washington DC 20510

  • Oklahoma

    Sen. James Lankford
    Phone: (202) 224-5754
    316 Hart Senate Office Building
    Washington DC 20510

    Sen. Markwayne Mullin
    Phone: (202) 224-4721
    330 Hart Senate Office Building
    Washington DC 20510

  • Texas

    Sen. John Cornyn
    Phone: (202) 224-2934
    517 Hart Senate Office Building
    Washington DC 20510

    Sen. Ted Cruz
    Phone: (202) 224-5922
    167 Russell Senate Office Building
    Washington DC 20510

  • Find Your House Representative

    Following a successful Senate vote, SB 2186 would then make its way to the U.S. House of Representatives. To contact your representative regarding this important issue, click on the link here and type in your zip code.