Extracorporeal Membrane Oxygenation (ECMO) is a life-saving treatment for critically ill patients with severe respiratory or cardiac failure. Although the technology was initially developed to facilitate open heart surgery, ECMO use expanded in the 1970s to support non-surgical patients whose organs were critically compromised. Similar to the transformative impact of dialysis or other groundbreaking medical advancements, the effectiveness of ECMO has consistently improved over time. This progress is largely attributable to technological enhancements, streamlined education for healthcare providers, and an abundance of rigorous research dedicated to optimizing patient outcomes. In the last decade, survival rates for ECMO have reached 73% for veno-arterial (VA) ECMO and 71% for veno-venous (VV) ECMO for patients who survived the first 30 days, providing a second chance at life to patients who would have otherwise died.
Despite the fact that nearly 1 million Americans could benefit from ECMO every year, only 10,000 currently receive it—this represents a mere 1% of the potential patient population. Yet, even coupled with the promising survival rates and the opportunity to be at the forefront of medical innovation, many hospitals have been reluctant to establish ECMO programs. This reluctance is largely fueled by persistent misconceptions about the profitability of such programs, leading to an unfortunate hesitation to embrace this life-saving technology. This reluctance not only prevents potential life-saving treatment for critically ill patients but also bypasses a significant untapped revenue source that could bolster the financial stability of these healthcare institutions.
The reality of ECMO's financial impact paints a different picture from the prevailing myth of economic impracticality. ECMO is, in fact, one of the most profitable services a hospital can provide. Among Medicare-covered admissions, ECMO receives the third-highest payment possible within their Diagnosis-Related Group (DRG) payment model. For patients covered by Medicaid, the reimbursement for this life-saving service is consistently in the top 5 and often the highest reimbursed intervention in most states. The net revenue of ECMO is often hundreds of thousands of dollars per case for Medicare and Medicaid, and can be over $1 million per case with commercial payers. In addition to the DRG or per diem rate, many ECMO cases fall into “outlier” or “stop-loss” status due to the high charges associated with this care. That status adds additional payments to the baseline rate, which can add significant revenue per case.
