Medicare Matters: Protecting Access to Transplants for Patients 65 Years and Older

Posted March 25th, 2016 by Be The Match and filed in News
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During the last several years, scientific advances have expanded access to bone marrow and cord blood transplants to patients who are 65 years and older. Last year, more than 1,000 patients in this age group received a life-saving transplant.

For this group of patients, Medicare is their primary insurer. While Medicare has agreed to cover these transplants in some instances, the amount it pay hospitals does not cover the full cost of obtaining the cells for transplant or the services provided.

The average cost to obtain stem cells is $51,727. The current Medicare payment rate for all the cells and all of the services provided is on average only $62,245. In many instances, hospitals cannot cover the total cost of obtaining the cells for transplant under the current rates and are left with nothing to cover the patient’s hospital stay, which can be as long as 30 days.

Be The Match®, operated by the National Marrow Donor Program, is concerned that hospitals cannot sustain such financial losses, threatening access to transplant for Medicare patients. We are currently working with the federal government to solve this problem. Our hope is that these cells will be treated the same as solid organ transplants so hospitals are reimbursed for both the cells and the transplant.

Medicare reimbursement rates should not create a barrier to access. Treating bone marrow and cord blood like solid organs will allow more patients in need of a life-saving transplant access one.

6 Responses to “Medicare Matters: Protecting Access to Transplants for Patients 65 Years and Older”

  1. Dear Dr. Boo,

    Reimbursement for BMT has been so low for so long, it is hard to believe anything will change. Good luck.

    Sarah

  2. Sarah H says:

    Hello,
    If I am reading this correctly, the total to just get the stem cells is $51,xxx and Medicare will only pay $61,xxx, give or take on my money numbers. So you are saying that it leaves nothing for the actual hospital stay before/after the stem cell transplant?? Don’t Medicare patients have/required a supplement that covers/pays what Medicare doesn’t cover??

    i know this may sound harsh but I will quote a saying that my grandfather told me: ” If you can’t afford something, then don’t do it or get it.” And that can mean you will not live . And I know that it is harsh but if you can’t afford to pay for a stem cell transplant or the care before or after then you can’t get one. It’s that simple. And that can apply to any age of a person.

  3. Florence says:

    Sarah says – die! I don’t think your grandfather was talking about life and health! More than likely in his lifetime, since stem cell transplant was probably not known, he was talking about owning a car, buying a house, shoes, clothes. I cannot imagine anyone saying to die because you can’t afford the medicine or operation. It has happened and is happening but we have to work to get this changed!

    • Sarah H says:

      Actually he was talking about health care. He was put in the spot 7 yrs ago when he got sick and the only thing that would save him was a stem cell transplant. His insurance would not cover the cost of the transplant and Medicare refused to pay for it also because it was not the normal thing to do for his cancer. And that is when he told me the quote. My grandfather passed away because he could not get a transplant. And there was no way we could afford to pay for one. We let nature take its course. Unfortunately it happens every single day to people and they are denied by their health insurance companies and Medicare.

      • Gina says:

        I am so sorry to hear that. I wish he could have had help. I know if I ever need one I won’t be able to afford it either.

  4. Marisol says:

    Soy madre de un hijo de 15 años de edad fallecido el 13 de febrero del 2016 tratado aqui en un hospital cede de sant jude hicieron todo lo posible hasta el ultimo momento pero su enfermedad era tan fuerte que necesitaba un trasplante de medula fue diagnosticado con leucemia linfoblastica aguda con células “T” me hubiera encantado demostrarle a mi hijo que en la humanidad no hay diferencias ni clases sociales y que cuando esta por enmedio una enfermedad como esta todas las personas nos unimos para salvarle la vida a un niño asi que espero de verdad ayuden y le brinden una oportunidad de vida otros niños del mundo les habran sus puertas ya que todos merecen una esperanza de vida, supliqué ayuda por varios medios correos que estuve esperando para poder trasplantar a mi hijo y nadie me respondió soy Guatemalteca y me encantaría si puedo ayudar a un niño con su enfermedad estoy a sus ordenes gracias.

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