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 recovery time.
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.
Related healthcare insights
Article
There’s a lot at stake with organ transplant claims. Learn the importance of selecting an effective payment integrity approach.
Article
Learn more about how an all-in, centralized claims review can contain costs while boosting consumer and provider experiences.
Article
See 4 ways that payers can help healthcare providers unlock the power of real-world data to drive quality and innovation in cancer care.
Complementary solutions
Transplant Resource Services
Transplant Solutions
- Repriced claims data from transplant cases managed by Optum. August 2024.
- 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.
- Optum Transplant network status August 2024.
- Count of 2023 transplant cases in CMC Facets, August 2024.
- Data based on the Optum COE network as of February 2022 and the U.S. Census Population Estimate sample.
- Count of 2023 cases created in CMC Facets, Aug. 2023.