Tag Archives: Scott Bentley

Infographic: Key findings on the cost of organ and tissue transplants in the United States

Milliman’s triennial report, “2020 U.S. organ and tissue transplants: Cost estimates, discussion, and emerging issues” provides a summary of estimated U.S. average utilization, billed charges, and resulting per member per month costs for organ and tissue transplants. It also explores projected trends in hospital waiting times, survival rates, and emerging innovations and issues in the transplant space.

The infographic below illustrates key findings and trends from the report.

Milliman report on U.S. organ and tissue transplants projects 11% rise in average annual cost in 2020

Milliman today released the 2020 edition of its triennial report on the estimated costs of U.S. organ and tissue transplants. The report summarizes average annual costs per member per month (PMPM), including utilization and billed charges, related to the 30 days prior through 180 days after transplant admission for organ and tissue transplants. This includes single-organ transplants such as heart, intestine, kidney, liver, lung, and pancreas, and a number of multiple-organ transplants. Tissue transplants include bone marrow and cornea.

While the findings vary greatly by transplant and population type, the study found that, for all combined organ and tissue transplants, per member costs based on billed charges saw an average annual increase of 11% for those under age 65, and 10.5% for those age 65 and over when compared to the 2017 report. The analysis also examined trends in hospital lengths of stay, average waiting times for organs, and changes in survival rates between our 2017 and 2020 reports, with results varying by transplant.

New this year, the report also explores emerging innovations and issues in the areas of organ viability and availability, such as the use of bioengineering, xenotransplantation, and anti-hepatitis C drugs to combat shortages and growing wait lists.

There are a number of scientific and policy initiatives geared at improving the availability of and access to much needed organ and tissue transplants. As new technologies emerge, Milliman’s research will continue to be an important tool for physicians, insurers, and the public to better understand the utilization, billed charges, and related trends associated with this vital healthcare service.

To view the complete report, click here.

Infographic: The cost of organ and tissue transplants in America

Organ and tissue transplants are a vital but expensive healthcare service in the United States, but there is little research available that measures transplant cost trends. The 2017 edition of Milliman’s triennial report was released in August and provides a better understanding for providers, insurers, and consumers of the billed charges associated with organ transplantation.

Recently, Milliman released an infographic that sums up the key findings in the report. A similar infographic was featured in the September issue of Fortune magazine and in the September 14th online edition.




Milliman report on U.S. organ and tissue transplants finds slight rise in average annual cost, survival rate overall

Milliman has released the 2017 edition of its triennial report on the estimated costs of U.S. organ and tissue transplants. The report summarizes average annual costs per member per month (PMPM), including utilization and billed charges, related to the 30 days prior and 180 days after transplant admission for organ and tissue transplants. This includes single-organ transplants such as heart, intestine, kidney, liver, lung, and pancreas, and a number of multiple-organ transplants; tissue transplants include bone marrow and cornea.

While the findings vary greatly by transplant and population type, the study found that, when compared to all combined organ and tissue transplants in the 2014 report, billed charges saw an average annual increase of 3.5% for those under 65, and 7.7% for those over 65. The analysis also revealed a dramatic decrease in wait times for kidney transplants and intestine transplants, while wait times for organs such as heart and pancreas have increased since the 2014 report. Survival rates have generally increased slightly when compared to Milliman’s previous report.

Organ and tissue transplants are a vital but expensive healthcare service, and the costs for these transplants are not readily available. This research is an important tool for providers, payers, and the public to better understand the utilization and billed charges surrounding organ and tissue transplantation.

To view the complete report, click here.




Supplementing insurer’s Medicare product portfolio

Some carriers can benefit from offering Medicare Supplement (MedSupp) as an alternative to Medicare Advantage (MA). In this article, Milliman consultants Ken Clark and Scott Bentley discuss the following four reasons why carriers should consider adding MedSupp to their Medicare product line:

• Enrollment of seniors who otherwise won’t enroll in MA
• Enrollment of seniors in service areas where developing an MA provider network isn’t practical
• A potential hedge against a decrease in the value of MA products for consumers
• Simplicity and flexibility for the health plan




2014 U.S. organ and tissue transplant cost estimates and discussion

This 2014 report summarizes estimated U.S. average costs per member per month, billed charges, and utilization related to transplant admission for treatment for organ and tissue transplants. There are some new developments to report since 2011 when the last report was released. Since that time, there have been annual increases in per member per month costs for certain types of transplants. Survival rates have generally shown mixed improvement and decline by transplant. However, hospital lengths of stay for most transplants have not changed much since the 2011 report.