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Managed Transplant Program: Reinsurance Carve-out

Managed Care Organization Benefits

The Managed Transplant Program (MTP) allows you to outsource the risk for transplants by paying a standard monthly premium. MTP will then pay virtually all claims that result from transplant cases.

MTP accomplishes these benefits:

  • Eliminates volatility via first-dollar transplant coverage through Optum, turning transplant costs into a stable budget item
  • Allows you to focus attention on other high ROI areas of your business
  • Frees up dollar reserves, allowing you to reinvest in your business
  • Eliminates needless costs by using Optum's Centers Of Excellence network and clinical management team to accomplish these results better than their average peer facilities:
    • Avoiding inappropriate transplants
    • Identifying eligible patients for Medicare
    • Reducing re-transplant rates
  • Reduces costs of health reinsurance premium
  • Covers all transplant-related costs, including immunosuppressants (anti-rejection drugs)
  • Covers the following transplant types:
    • Solid organ
    • Blood and marrow
      • Bone marrow
      • Cord blood
      • Stem cell
  • Covers all transplant-related expenses from one day prior to the transplant through a maximum of 365 days following the transplant
  • Includes coverage for evaluation, search and registry, organ procurement, home health, outpatient treatment, and travel and lodging benefits

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