Release of the 2025 Milliman Study: Implications for Life Care Planning in Lung Transplant Litigation

The release of the 2025 Milliman study on U.S. organ and tissue transplantation costs marks a significant update in the actuarial analysis of transplant-related expenses. This report, authored by Nick Ortner and Hanna Holzer of actuarial and consulting firm Milliman, provides detailed estimates of billed charges, utilization rates, and costs per member per month (PMPM) for various organ transplants, including single and double lung transplants. Compared to its predecessor, the 2022 Milliman study, the 2025 report incorporates a broader dataset and reflects updated methodologies that account for evolving market conditions and healthcare trends. For legal professionals and life care planners involved in litigation surrounding lung transplants, this report serves as a critical resource for estimating future costs. 

One of the key advancements in the 2025 Milliman study is its expanded use of data sources, including the Milliman Consolidated Health Cost Guidelines Sources Database (CHSD) and Medicare Limited Data Sets (LDS). These additions provide a more comprehensive view of transplant costs across different payer systems, enhancing the accuracy of projections. In contrast, the 2022 study relied on narrower datasets and did not fully account for post-pandemic shifts in healthcare utilization. For instance, while both reports provide cost estimates for single and double lung transplants—$1,810,700 and $2,346,500 respectively in 2025—the newer report reflects annual increases in billed charges and utilization rates that are more aligned with current market realities. 

The utility of Milliman studies in life care planning for litigation purposes lies in their detailed breakdown of transplant-related costs. These include pretransplant medical expenses, organ procurement charges, hospital admission fees, physician services during hospitalization, post-transplant follow-up care, and outpatient immunosuppressant therapies. Such granularity allows attorneys and life care planners to construct robust financial models for future medical needs. 

 However, one notable limitation is the study's reliance on national averages, which may obscure significant geographic variations in transplant costs. For example, lung transplant expenses can vary widely between urban centers with high transplant volumes and rural areas with limited access to specialized care. Despite its strengths, the Milliman study has limitations that warrant careful consideration. While the report provides valuable insights into average costs across age groups and transplant types, its applicability to geographically sensitive pricing remains limited. This poses challenges for litigation cases where regional disparities play a critical role in determining damages or settlement amounts. Additionally, the study is limited to costs billed during the pre-transplant hospitalization (approximately 30 days) as well as costs billed during the first 180 days post-discharge. This limitation requires the life care planner to supplement additional lifetime costs using other methods. 

While the 2025 Milliman study represents an important tool for estimating lung transplant costs in legal contexts, its limitations must be acknowledged. Legal professionals should supplement Milliman data with localized cost analyses to ensure accurate life care planning. Future iterations of these reports could benefit from incorporating geographically stratified pricing models to address this critical gap. Nonetheless, the study's comprehensive approach to cost estimation continues to make it an indispensable resource for litigation involving complex medical procedures like lung transplantation.