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UNITED BLOOD SERVICES AGREEMENT
Executive Summary
The United Blood Services (UBS) agreement is to provide blood products for University Medical Center. United Blood Services is the only local community blood center in the El Paso area. For this reason, the agreement is considered sole source. The three year agreement will commence on December 1, 2016 thru November 30, 2019.
The Laboratory has worked with United Blood Services for over twenty years and is pleased with the service provided. The only other option would be with the American Red Cross based in Dallas, Texas. In the past, UMC worked briefly with the American Red Cross and the products were not delivered within acceptable time frames. The products had to be shipped via airlines from Dallas to El Paso with delivery only once per week. The end result was the need to purchase blood products from United Blood Services at list price which is more costly. This would occur on weekends, traumas and holidays, as the Red Cross was consistently short of products.
Based on par levels, routine replacement additions must be delivered within four hours of order and emergent orders within thirty five to forty five minutes. UBS will provide packed red blood cells, platelets, fresh frozen plasma. UBS will also provide irradiated products for patients that are immuno-suppressed (Chemotherapy treatment). UBS averages 35 minutes or less delivery time of urgent (e.g. trauma patients) blood product requests.
The attached fee schedule shall remain constant for the duration of the agreement. The only increase would be if additional testing is mandated by the FDA. (E.g. Zika Virus). The UBS fee schedule has remained constant since October 2013 with no price increases. This proposed pricing reflects a 1.5% to 2% discount from the 2013 rates.
The Laboratory Director assures fair market pricing from UBS by comparing fee schedules to other community blood centers across Texas. New Mexico and Arizona are also supplied by UBS, i.e. Banner Hospital System.
Cost
FY 2012 $2,590,808
FY 2013 $2,543,961
FY 2014 $2,347,931
FY 2015 $2,492,820
FY2016 $2,502,858
The Laboratory assures appropriate usage and cost by reviewing the C/T ratio and Hemoglobin levels continuously.
FY 2016 Cumulative C/T ratio = 1.82
Threshold (National) = <2.00
The National (American Association of Blood Banks) acceptable threshold for cross-matched blood orders to used blood product is < 2:0. That means anything above two units requested and none used is inefficient and costly. UMC-EP is 1:82 which is below the National threshold. The services using high volume of blood products are Trauma, Oncology, OB, Orthopedic Surgery and elective surgeries.
UMC Laboratory is now providing the care providers with thromboelastographic (ROTOM) testing. This will show what blood products should be used and will also provide results showing when the products transfused are correcting the bleeding issue. This procedure has reduced the blood product bill by $54,000 the first three months of usage (May, June and July, 2016). The products are packed red blood cells, fresh frozen plasma and platelets.
For these reasons, UMC recommends the continuation of services by United Blood Services for the next three years at a maximum not to exceed cost of $2,500,000 per year.
Fee Schedule for Blood Products and ServicesBill Code / Product/Service Description / Fee
Red Blood Cells Leukocytes Reduced / $220.00
Red Blood Cells Irradiated Leukocytes Reduced / $292.00
Red Blood Cells Leukocytes Reduced (Aliquot/Pedi Pak) / $290.00
Fresh Frozen Plasma/FP24 / $72.00
Cryoprecipitate AHF / $72.00
Cryoprecipitate AHF Pooled / $390.00
Apheresis Platelets Leukocytes Reduced / $595.00
Apheresis Platelets Irradiated Leukocytes Reduced / $667.00
05M-01-000 / Autologous Fee / $70.00
06M-01-000 / Directed Donor Fee / $70.00
40M-01-000 / CMV Test – Donor / $72.00
41M-01-000 / HgS Sickle Cell Test – Donor / $72.00
53M-01-000 / Stat (Delivery) Service (Weekends/Holidays) / $65.00
73M-01-000 / Irradiation Fee / $72.00
75M-01-000 / STAT Charge - On Call after Hours Charge/Weekends/Holidays / $150.00
Bill Code / Specialty Products Description / Fee
21M/29400 / ABO & Rh Type / $52.00
29405 / Antibody Detection (Screen) / $67.00
99827 / Antibody Detection (Screen) – Gel / $103.00
29436 / Computer Unit Search / $125.00
22M/29415 / Antigen Typing, DONATION (per Antigen) / $72.00
23M/29417 / Antigen Typing, Rare – DONATION / $155.00
29407 / Antibody ID / $103.00
STAT Charge (any case requested as STAT regardless of time of day or day of week) / $250.00