*Purpose: Hispanic/Latinx patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites. [Institution name’s] culturally targeted Hispanic Kidney Transplant Program (HKTP) was found to increase LDKTs in Hispanics at one of two transplant programs with greater implementation fidelity. We conducted a budget impact analysis to evaluate the HKTP’s impact on program financial profiles based on the volume of LDKTs in 2017-2019.

*Methods: We estimated HKTP costs using monthly time studies and transplant staff hourly costs. Transplant costs and revenues were estimated based on payor mixes. Financial estimates were validated by transplant program’s financial staff. We forecasted years 2022-2024 transplant volumes, HKTP costs, and transplant program costs and revenues based on years 2017-2019.

*Results: The costs of the HKTP were 1% of the total LDKT costs and revenues in 2017-2019 at both programs. Annual revenues (2017-2019) from HTKP LDKTs increased by 354.2% at Site A, and by 297.8% at Site B. Time investment in HKTP implementation at Site A increased by 55.6% for 2017-2018 and 44.8% for 2018-2019, resulting in HKTP costs to increase 30.2% for 2017-2018 and increase 44.4% for 2018-2019. As a result, HKTP LDKT revenues at Site A increased 61.9% for 2017-2018 and 180.5% for 2018-2019. Total time investment in HKTP implementation at Site B decreased 24.8% for 2017-2018 and decreased 8.5% for 2018-2019 resulting in total HKTP costs to decrease 27.2% for 2017-2018 and decrease 20.9% for 2018-2019. As a result, HKTP LDKT revenues at Site B increased by 138.0% for 2017-2018 and increased 67.6% for 2018-2019. From 2022-2024, the projected impact of HKTP costs relative to total organ acquisition costs was 3.0% at Site A, and 1.0% at Site B, while the HKTP costs relative to the total revenues was less than 1% at both Sites. HKTP LDKT volume was projected to increase 36.4% at Site A and 33.3% at Site B, with an increase in revenues by 46.0% at Site A and by 43.0% at Site B.

*Conclusions: Investment in time and resources in the HKTP intended to reduce health disparities and improve equity in kidney transplantation had a minimal impact on overall LDKT program costs with potential increases in total revenues. Because HKTP costs are potentially recovered by reimbursement of organ acquisition costs and minimized by increases in total LDKT revenues, transplant programs may find reducing health disparities to be financially manageable.

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