Over the years as I have consulted for ECMO programs and talked with Administrators, Physicians, etc. as well as ECMO Specialists, a common question has been: “What does it cost to run an ECMO program?”. Or, “What does it cost to provide ECMO support?” What is the cost of ECMO support? And although it’s often unstated, the underlying question may be, Is this really worth it? We are spending a LOT of money and resources on a small number of patients. Could the expense be put towards other services, or modalities, or resources that could make a much bigger difference for a larger patient population? Is the cost of ECMO really better than providing standard care without ECMO?
I think for most ECMOlogists…we answer that with a resounding “YES! It’s worth it.” But can we really justify it financially?
Well, I won’t bore you with all the details, but suffice it to say, there is a lot of debate surrounding these questions. The answers to these questions are often contested as well. Most reports that I have found over the years typically use terms like “Quality Adjusted Life Year” (QALY) to help create a standard for comparison. Or another common phrase you may see in literature is “cost per life year”. And you may hear people talk about cost effectiveness or cost effectiveness ratios. There’s a life time of reading and debate just regarding the terms or methods used to determine value of a medication, therapy, or modality.
So here are just a few reports that may indicate support for the expense:benefit ratio of ECMO.
- Venoarterial extracorporeal membrane oxygenation may be cost effective in treating cardiotoxicant poisonings. Oct 2014
- Use of ECMO in this way is likely to be cost-effective when compared with other technologies currently competing for health resources. (CESAR Trial). July 2010
- This study provides rigorous evidence of the cost-effectiveness of neonatal ECMO during childhood. May 2006
- Salvage cardiac extracorporeal membrane oxygenation results in reasonable survival and is justified on a cost-utility basis. June 2004
- ECLS affects survival favorably, and compares favorably when considering cost/life-year calculations . Sept 1998
Then there is the whole issue of what does it cost the hospital versus how will insurance reimburse the hospital? This may be a topic for another post.
We address these issues in our ECMO Consulting Services. We have also added a new service feature that provides access to reimbursement specialists to help our clients learn to properly code, bill, and seek reimbursement for extracorporeal related services. This is particularly important with all of the changes that occurred in 2015.
So what do you say? The cost of ECMO…Is it worth it?
Contact us if we can assist your program with any of these issues.
Randy Bartilson, President of ECMO Advantage – Serving the ExtraCorporeal Community.