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Congenital Heart Disease Resource Services

One out of every two pediatric heart transplants is a Congenital Heart Disease (CHD) case. To help improve treatment and outcomes, OptumHealth has developed Congenital Heart Disease Resource Services, complementing the expertise within the Transplant Resource Services Centers of Excellence network.

OptumHealth’s Congenital Heart Disease Resource Services provides guided access to a network of evaluated CHD centers and nurse consulting services. Through the “three Cs” — Credentialing, Contracting and Consulting — CHD Resource Services helps patients and their families better understand and manage CHD and its associated conditions.

 

The “Three Cs" of CHD Resource Services:

  • Credentialing — identifying the best programs in the field of CHD.
  • Contracting — achieving significant savings through contracts specifically designed around CHD procedures.
  • Consulting — providing clinical data to guide payers and members to the most appropriate program.

CHD Resource Services Offers Savings Through Centers of Excellence Network

Congenital heart defects are structural problems with the heart that are present at birth. They are the most common birth defect and the number-one cause of death from birth defects during the first year of life.

Once a CHD is detected, the primary treatment is surgery. Treatment costs for severe CHD cases average $290,000 per episode and can exceed $1,000,000. Inpatient facility charges represent a substantial portion of these treatment costs.

Using OptumHealth’s Centers of Excellence network, CHD Resource Services can yield savings of 35–40 percent, helping to reduce the financial risk associated with CHD treatment.