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Solution suite

Managed Transplant Program for Health Plans

With the Managed Transplant Program (MTP), health plans can better manage risk, control costs and improve transplant service.

Effective protection against the high cost of transplant services

MTP combines the Optum Centers of Excellence (COE) network with clinical expertise and claims adjudication knowledge to offer cost management and risk protection against high transplant medical expenses.    

  • High-cost care: The average billed charges for a transplant episode can quickly rise to $1 million or more.1
  • Significant health plan exposure: For a 100,000-life group, there is $17 million of transplant exposure.2
  • Transplant utilization on the rise: 1 in 5,300 members will experience a transplant.2
  • Experience and scale: We have over 35 years of experience managing transplants.

Related expenses are covered post-transplant for one year

Reduce the risks involved with transplant services

Our solutions are a step towards reducing the risks that come with:

  • High transplant volumes
  • Transplant complication costs
  • Re-transplantation
  • Reinsurance trend increases

The Managed Transplant Program for Health Plans is also a valuable tool that may reduce clinical, case or claims errors.

A solution that can harness out-of-control costs

MTP is a management tool that can effectively curb transplant costs. Use it to lower or eliminate:

  • Reinsurance premiums
  • Payer costs
  • Deductibles due in consecutive years
  • Time to transplant and the related costs of delays

Deliver a better transplant experience

The experience and scale offered by our Managed Transplant Program means that health plans can improve the experience associated with transplant services. Our solutions can reduce length of stay and time to recover.

Health plans can harness MTP to:

  • Reduce unnecessary transplants
  • Maximize pharma compliance
  • Improve options through specialized physician review
  • Ensure full coverage for treatments

Key benefits

The Optum Transplant Centers of Excellence network delivers access, choice and exceptional value.

195 transplant centers of excellence facilities

We have 195 COE facilities and 1,112 COE programs.3

Millions of members have access

Our more than 95 million members have access to quality care.4

Proximity to a COE

Approximately 98% of members are within 200 miles of a COE.5

Continual service

Almost 1 transplant is performed per hour in network.6

Fact sheet

A risk-free transplant solution

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

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Product information and resources

  • PDF

     

    Fact sheet

    Transplant solutions

    Transplant Solutions can help provide clinical and economic value to organizations managing the catastrophic care of transplants.

    Download fact sheet
  • PDF

     

    Fact sheet

    Transplant resource services

    Our transplant Centers of Excellence network is at the heart of how we help Commercial, managed Medicaid and Medicare Advantage payers.

    Download fact sheet

Partner with an experienced managed transplant program

Complementary solutions

Transplant Resource Services

We offer a high-quality nationwide provider network of transplant centers and significant discounts.

Transplant Solutions

Get significant savings and statistically better clinical outcomes.
  1. Repriced claims data from transplant cases managed by Optum. August 2024.
  2. Ortner N, Holzer H. 2025 U.S. organ and tissue transplant cost estimates and discussion. Milliman, Inc. Published Feb. 13, 2025. Accessed Mar. 11, 2025. Milliman estimated U.S. average billed charges related to 30 days prior to and 180 days after transplant for the population under age 65.
  3. Optum Transplant network status August 2024.
  4. Count of 2023 transplant cases in CMC Facets, August 2024.
  5. Data based on the Optum COE network as of February 2022 and the U.S. Census Population Estimate sample.
  6. Count of 2023 cases created in CMC Facets, Aug. 2023.