The average billed cost for a transplant episode is $427,0001, but depending on the circumstances, it can rise to $1 million or more.
OptumHealth’s transplant programs operate the nation’s leading Centers of Excellence (COE) transplant network. We develop and maintain the transplant network using a process of qualifying, contracting and case management consulting unique to the industry. There are two programs available, Transplant Resource Services (TRS) and the Managed Transplant Program (MTP).
Transplant Resource Services
Our most aggressive and predictable contracting is prevalent within the Transplant Centers of Excellence network. Clients save an average of 49 percent2 per transplant episode, in addition to the cost avoidance achieved through the statistically superior clinical outcomes realized through COE network programs. Savings are an integral component of the transplant network product design.
Managed Transplant Program
Transplant costs can be extremely unpredictable for employers. OptumHealth manages the clinical and financial aspects of your transplant cases through our “carveout” product. We can help advance your strategy for controlling costs, mitigating risk and improving patient outcomes.
Both transplant programs include transplant nurse case managers to help guide patients through every aspect of the transplant process, including evaluation, pre-transplant, transplant, post-transplant, transportation arrangements, lodging and aftercare. Our transplant nurse case managers assist patients in making informed decisions about their transplant care through education and access to our quality network.
1 Milliman 2008
2 OptumHealth data, 2009