Optum offers products for complex medical conditions such as:
Bariatric
Cancer
Chronic Kidney Disease
Congenital Heart Disease
Orthopedics
Transplantation
VAD
Women's Health Services
- Fertility
- Neonatology
- Pregnancy

 

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Transplant Resource Services: Cost Savings

Low Incidence, High Cost

Transplant costs can be extremely unpredictable. According to leading industry researchers Milliman USA, transplantation affects 146 people per million lives, and the average billed cost for a transplant episode is $598,000.1 Depending on circumstances, costs for one transplant case can rise to more than $1 million. 

To mitigate these high costs, Optum Transplant Resource Services (TRS) provides a clinically superior network of facilities with whom we negotiate contracts. Through TRS network access, clients save an average of 54% on standard charges per transplant episode.2

Comprehensive contracts

Optum selects Centers of Excellence Network medical centers through a process of quality measurement and value-driven contracting that is unique in the health care industry. Optum contracts address 100% of the total transplant cost, while similar services address only 60% of those costs. We cover all phases of patient health care:

  • Evaluation
  • Pre-transplant
  • Transplant
  • Post-transplant
  • Twelve-month follow-up health care

 

Sources:
1. McGillis. Analysis of Hanson S., Bentley T. 2014 U.S. organ and tissue transplant cost estimates and discussion. Milliman, Inc. http://www.milliman.com/uploadedFiles/insight/Research/health-rr/1938HDP_20141230.pdf. Published December 30, 2014; Accessed January 20, 2015. Accessed January 20, 2015. Average transplant incidence and cost estimates based upon data from the population under 65 years old.     
2. Optum re-priced claims (Facets) 2014