Organ Transplant Center Outcomes Forensic
SRTR is 18 months stale.
The deterioration signal isn’t.
SRTR is the canonical transplant center outcomes registry — but its methodology is contested and its data is roughly 18 months behind current performance. Branmoor runs a shadow registry that combines SRTR with CMS cost reports, OPTN policy violation records, CMS survey findings, and insurance carve-out network data. More current. More sources.
Free patient-facing surface. Paid institutional surface for centers, carve-out vendors, and employers.
Center-level signal — sample
For every U.S. transplant center: SRTR published outcome, shadow-registry composite, OPTN citation history, and cost report trajectory. Where the two signals diverge, the shadow registry is typically more current.
| Center | Organ | SRTR Rating | Shadow Signal | OPTN Citations (3yr) | Volume Trend |
|---|---|---|---|---|---|
| Center A (Composite) | Kidney | As Expected | Deteriorating | 2 | ↓ −18% |
| Center B (Composite) | Liver | Better than Expected | Stable | 0 | ↑ +11% |
| Center C (Composite) | Heart | As Expected | Early signal | 1 | ↓ −8% |
| Center D (Composite) | Kidney + Pancreas | Worse than Expected | Confirmed deterioration | 4 | ↓ −31% |
| Center E (Composite) | Lung | As Expected | Stable | 0 | ↑ +6% |
Sample using composite centers. Shadow signal is a composite of OPTN citation history, CMS cost report volume trajectory, CMS survey findings, and where available, insurance carve-out network steering data. SRTR rating is CMS-published; shadow signal is Branmoor-computed. Divergence alerts are the core paid product.
Why SRTR isn’t enough
18-month publication lag
SRTR's most recent outcomes report reflects performance from roughly 18 months ago. A center that began deteriorating 12 months ago will not appear in SRTR for another 6 months — at minimum. The shadow registry is continuous.
Contested methodology
SRTR's risk-adjustment methodology has been criticized in peer-reviewed literature for overadjusting for donor quality and case mix in ways that mask center-level performance variation. The shadow registry uses alternate risk models and discloses them.
Volume is the leading indicator
Transplant center volume decline precedes outcome deterioration. When a center starts losing referrals — from surgeons, carve-out networks, or patients — volume drops before SRTR sees the outcomes. CMS cost reports show volume; SRTR does not update in real time.
OPTN citations are public and underused
OPTN's Membership and Professional Standards Committee publishes policy violations and corrective action plans. They are rarely cross-referenced against SRTR. A center with active OPTN citations and deteriorating shadow signal is a different risk profile than SRTR alone suggests.
Who it serves
Transplant candidates and families
Free. SRTR tells you where a center was 18 months ago. The shadow registry tells you where it is now — and whether the trajectory is improving or deteriorating. For a candidate on a multi-year waitlist, this is a consequential input.
Insurance transplant carve-out vendors
Optum Transplant Solutions, Interlink Health, and their competitors steer covered lives to preferred centers. The steering criteria need to be defensible and current. The shadow registry provides both, with source linkage for each signal.
Self-insured employers with transplant exposure
Employers with transplant-heavy populations (older workforce, certain industries) can use the shadow registry to evaluate network steerage and Centers of Excellence contracts before renewal — not after a claim.
Primary data sources
| Source | What it provides | Update cadence |
|---|---|---|
| SRTR public reports and PSR data | Outcome measures, expected vs. observed performance by organ and center | Semi-annual (with 18-month lag) |
| OPTN policy violation records | MPSC citations, corrective action plans, board referrals | Continuous (event-driven) |
| CMS Medicare cost reports | Volume trajectory, cost behavior, ownership changes | Annual |
| CMS Conditions of Participation survey findings | Survey citations specific to transplant programs | Continuous |
| Insurance carve-out network data | Optum and Interlink steering criteria where publicly published | Annual or event-driven |
Inquire about access
Organ Transplant Center Outcomes Forensic is sold under named institutional license. Carve-out vendor and employer pricing is per engagement. Transplant center access for benchmarking is available under a separate rate.