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Managed Transplant Program for Health Plans

With the Managed Transplant Program (MTP), the plan can better manage risk, control costs and improve patient outcomes.

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Effective protection against the high cost of transplant claims

MTP combines access to the Optum nationwide Centers of Excellence transplant network with specialized clinical expertise and years of claims adjudication knowledge. This offers unmatched cost management and risk protection against the high cost of transplant medical expenses.

High-cost care

Average billed charges range from $409,000 to $2.6 million, depending on transplant type.

Significant health plan exposure

For a 100,000-life group, there is $13.2 million of transplant exposure.

Transplant utilization on the rise

1 in 5,600 members will experience a transplant.

Experience and scale

We have over 30 years of experience managing transplants.

Fact sheet

A risk-free solution

MTP offers an easy way to manage claims and control uncertain transplant costs while improving the health of patients.

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Related expenses are covered through one year post-transplant

  • Reduce transplant mix risk
  • Reduce risk of high transplant volumes
  • Reduce risk of transplant complication costs
  • Reduce re-transplantation risk
  • Reduce risk of reinsurance trend increase
  • Reduce risk of clinical, case or claims errors

  • Lower reinsurance premium costs
  • Minimize payers’ cost via coordination of benefits
  • Outsource case and claims management
  • Eliminate deductibles
  • Eliminate average daily maximums (ADMs)
  • Reduce dual deductibles in consecutive years
  • Minimize time to transplant and related costs

  • Reduce length of stay, time to recovery
  • Reduce unnecessary transplants
  • Maximize pharma compliance
  • Specialized physician review improves options
  • $2 million or unlimited benefit ensures full coverage

White paper

Improving post-transplant clinical outcomes

Learn about the value of organ transplant programs.

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Article

Lifesaving CAR-T and transplant trends

Explore trends driving unprecedented levels of transplants and medical spend.

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5-Minute Brief

CAR T-cell and other ex vivo gene therapies

Plan your strategy to engage eligible patients.

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