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.