Transplant costs are increasing due to the broader availability of donor organs, which results in an increase in the frequency of claims. At the same time, the contracting methodology is moving away from fixed fee contracting to arrangements with minimum floor provisions, which are typically a percentage of billed charges.
Managed Transplant Reinsurance allows the health plan two different options to manage their transplant exposure;
- Management of transplants is shifted to a reinsurer while the client still retains the financial risk, or;
- The entire transplant risk is ceded to the reinsurer (carve-out), which would include both the medical management as well as the financial risks.
To learn more about managed transplant services at Dubraski & Associates, contact us.