Referral Rate and Approach Rate measures recognized through rigorous independent review by the Partnership for Quality Measurement

MCLEAN, Va., Oct. 27, 2026 /PRNewswire/ — The Association of Organ Procurement Organizations (AOPO) today announced that two new performance measures designed specifically for organ procurement organizations (OPOs) — the Referral Rate and Approach Rate — have been endorsed by the Partnership for Quality Measurement (PQM) following a national review and evaluation process.

Having these measures endorsed represents significant progress in AOPO’s multi-year OPO Performance Measurement Project, launched in partnership with 53 OPOs and Econometrica, Inc., to develop meaningful, evidence-based measures that provide a more complete picture of OPO performance and support continuous quality improvement.

“The endorsement of these measures through a rigorous, independent process marks an important milestone for the OPO community and for the patients and families our system serves,” said AOPO President, Allison Erickson. “Strong performance measurement should help organizations understand where opportunities exist, improve processes and quality, and ultimately increase the number of lifesaving organs available for transplant. These measures move us toward a more comprehensive and actionable approach to evaluating donation performance.”

PQM is operated by Battelle, which serves as the Centers for Medicare & Medicaid Services’ (CMS) Consensus-Based Entity for quality measure endorsement and maintenance. Through PQM, measures are evaluated through a transparent, consensus-based process designed to support health care quality improvement and accountability.

Building a More Complete Picture of OPO Performance

The endorsement comes at an important time for the nation’s organ donation system. Under the current CMS OPO performance framework, OPOs are evaluated using only two outcome measures — Donation Rate and Transplant Rate — that play a central role in determining certification and competition for OPOs.

Outcome measures are an important part of evaluating performance, but they cannot provide insight into every step that contributes to the number and type of organs available for transplant. Organ donation is a complex process involving hospitals, OPOs, transplant centers, patients and donor families, with multiple decision points along the way.

The newly endorsed Referral Rate and Approach Rate add another dimension by assessing critical processes earlier in the donation pathway. PQM classified these as process measures, and AOPO’s measurement framework is designed to examine how effectively potential donation opportunities move through key stages including referral, approach, authorization, donor care and donation.

“Outcome measures tell us what happened. Process measures can help us understand why it happened and where there may be opportunities to improve,” said Econometrica Health Practice Area Director, Dr. Jean O’Connor. “A strong performance measurement system should provide both perspectives, giving organizations meaningful information they can use to strengthen processes and improve performance.”

Measuring Critical Steps in the Donation Process

The Referral Rate measures hospital referrals of potential organ donors to the OPO within its donation service area. Timely and appropriate referral is one of the earliest steps in the donation process and creates the opportunity for OPOs to evaluate whether donation may be possible.

The Approach Rate evaluates whether eligible families are provided the opportunity to have a donation conversation. These conversations help ensure potential donors and families are given the information and support needed to understand donation possibilities and make informed decisions.

Together, the measures provide greater visibility into important points along the donation pathway and can help OPOs and their hospital partners identify variation, better understand performance and target quality improvement efforts across the organ donation system.

Built Through Collaboration and Evidence

Development of the measures has involved extensive participation from OPO teams, clinicians, researchers, quality experts, donor families and recipients, and other stakeholders throughout the donation and transplantation community, including site visits, data analysis, measure testing and opportunities for public comment and stakeholder feedback.

As part of the development process, a Technical Expert Panel and Stakeholder Group established criteria for evaluating potential and final OPO performance measures. The group agreed that measures should be meaningful, actionable, feasible to implement, rigorous, evidence-based, replicable and verifiable. They were also expected to reflect the evolving science and medicine of donation, align with the broader transplant system, promote improved transplant outcomes and be assessed for the potential to create unintended or unethical incentives.

“This work has always been about developing measures OPOs can use to learn, improve performance, and better serve donor families and patients waiting for transplant,” said AOPO CEO, Steve Miller. “PQM’s endorsement demonstrates the value of bringing together data, operational expertise, and diverse perspectives to build performance measures that reflect how organ donation actually works.”

AOPO will continue working with OPOs, policymakers and other stakeholders to support implementation and appropriate use of these measures to save more lives.

These are the first submissions from a broader set of performance measures being developed through AOPO. Additional measures focused on donor management, organ yield and utilization are expected to be submitted to PQM in November 2026, further expanding the framework for understanding OPO performance across the donation and transplantation continuum.

Learn more about AOPO’s OPO Performance Measurement Project and access resources by visiting https://aopo.org/opo-metrics-project/measures/.

About the Association of Organ Procurement Organizations (AOPO)
AOPO leads the nation’s organ donation community to save and improve lives through organ, eye, and tissue donation. Founded in 1984, AOPO advances organ donation and transplantation by driving continual improvement of the donation process, collaborating with stakeholders, and sharing successful practices with its 45 member OPOs. AOPO envisions a future where every opportunity for donation results in lives saved. Visit aopo.org to learn more.

Contact Information:
Jenny Daigle | jdaigle@aopo.org

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SOURCE Association of Organ Procurement Organizations