By Janelle Torres, Director, Corporate Accounts, California Specialty Pharmacy
As healthcare continues its shift away from fee-for-service and towards value-based or global payment models, hospitals are looking for ways to improve patient outcomes while simultaneously reducing costs. One promising area that works well with this new payment paradigm is the transitioning of infusion therapy patients away from the hospital setting into the patient’s home or an ambulatory infusion suite (AIS).
Hospitals, while no doubt equipped with skilled healthcare professionals and valuable cutting-edge technologies, can be among the most expensive sites in which to receive care. The cost of hospitalization, including room charges, staffing, supplies, and other overhead, can significantly increase the price tag of care well beyond the cost of the infusion therapy (or other treatment received) itself. Additionally, research has shown that the longer a patient stays in a hospital, the higher their risk for contracting a hospital-acquired infection (HAI), which can add even more time and cost to a hospital stay.1
Curbing Costs While Maintaining Quality Care
One key element of curbing the high costs associated with hospital stays, readmissions, and HAIs is to smartly identify patients who are stable enough to continue their care outside the hospital, and many patients receiving infusion therapy may fall into this category.
For example, consider a hospital with 800 acute-care beds that has the potential for 2,000 home infusion discharges on average per year. If a hospital of this size could transition just 25% (500) of those patients from hospital to home infusion one day earlier, the hospital would realize $1,500 in savings per bed, per day – resulting in potential Acute Stay Optimization Cost (ASOC) savings of $750,000.
As a premiere specialty infusion provider, California Specialty Pharmacy (CSP) works closely with hospital administrators, healthcare providers, discharge nurses, and other key stakeholders to help hospitals realize significant savings and reduce length of stay for infusion patients by providing the expertise necessary to accurately identify those infusion patients who may be eligible to receive their treatment elsewhere.
Identifying At-Home or AIC-Eligible Infusion Patients
The decision to pursue infusion therapy at home or at an ambulatory infusion center may be based on factors including the patient’s condition, their ability to manage their own care, their family/caregiver support network, and their overall health. Patients who may be best suited to receive infusion therapy outside the hospital setting may include those with chronic conditions or those requiring long-term treatments (so long as they are clinically stable), those with a suitable home environment, and those who can manage their therapy on their own or have a suitable caregiver who can assist them.
California Specialty Pharmacy works closely with hospitals to identify which patients are ideally suited for infusion therapy at home or at one of its AISs. This may include patients who require:
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- Antibiotics: IV antibiotics for conditions like chronic infections, osteomyelitis, or endocarditis.
- Nutritional support: Patients who need total parenteral nutrition (TPN) or other forms of nutritional supplementation.
- Intravenous Immunoglobulin (IVIG) therapy: For patients with autoimmune diseases, immunodeficiency disorders, or certain neurological conditions like multiple sclerosis (MS) or chronic inflammatory demyelinating polyneuropathy (CIDP).
- Cancer support: Chemotherapy, immunotherapy, or supportive care such as hydration and pain management.
- Hormonal or biologic therapies: Including treatments like erythropoietin for anemia or biologic drugs for autoimmune diseases (e.g., rheumatoid arthritis).
- Heart failure treatment: IV medications such as inotropes, diuretics, antibiotics and TPN.
While it sounds counterintuitive, moving infusion therapy out of the hospital may also provide greater continuity of care for the patient. When infusion therapy is provided in the hospital, it may often be the medical director at the hospital’s infusion center – rather than the patient’s original prescribing provider who oversees the patient’s infusion care. But when a patient’s infusion therapy is transitioned to CSP (whether at our AISs or we’re facilitating at-home care), CSP assumes the role and responsibility of infusion liaison.
This means that CSP’s staff communicates directly with the patient’s provider, verifies insurance options, identifies any areas of patient choice and/or provider preference, and can recommend appropriate treatment options as needed. As a result, the payment/reimbursement stays with the patient’s prescriber instead of being transitioned to the hospital, and the patient benefits from having their provider, who knows and understands their case, remain personally involved in overseeing and directing their care.
Of course, beyond the benefits to the hospital, a primary advantage of moving infusion therapy out of the hospital is the full range of advantages this site-of-care shift offers to patients – particularly those with chronic conditions, severe illnesses, or those requiring long-term treatment.
Key Advantages of Home- or AIC-Based Infusion Therapy for Patients
Some of the most common benefits to patients receiving their infusion therapy at an ambulatory infusion center or at home may include:
Convenience and comfort
Patients receive treatment in a more comfortable, private setting, with options for greater scheduling flexibility, so that treatment can more easily integrate into their daily routine and lifestyle.
Reduced risk of infection
Since the patient is not exposed to the hospital as frequently, home or AIS infusion therapy may result in a reduced risk of contracting hospital-acquired infections.
Cost-effectiveness
For many patients, receiving care at home or at an AIS may be less expensive than prolonged hospital stays or frequent outpatient visits, reducing the financial burden on the patient and their family.
Overall, patients receiving at-home or AIS infusion therapy may find that they are able to engage more fully in daily activities and maintain a higher level of independence. They may also appreciate having family or caregivers involved in the process, which may help with emotional support and enhance patient satisfaction.
The CSP personal touch
CSP’s specialty pharmacists, infusion specialists, and skilled nurses provide one-on-one care, closely monitor the patient’s progress, adjust treatments as necessary, and provide crucial patient education. The CSP team communicates directly with the patient’s prescribing provider to ensure the patient’s needs are met and that the treatment is progressing as expected. This integrated care model helps ensure that patients receive the best possible care.
The shift towards providing infusion therapy outside of traditional hospital settings is a win-win for patients and healthcare providers. From improved patient comfort and reduced risk of infection to cost savings for all parties, the benefits are undeniable. As healthcare continues to evolve towards the global payment model and patient needs become increasingly prioritized, the growing trend of delivering infusion therapy at home or in AISs promises to play a key role in shaping the future of healthcare delivery. Whether for chronic conditions or short-term treatments, this approach is helping to make infusion therapy more accessible, convenient, and cost-effective for the entire healthcare system.
References:
- Jeon CY, Neidell M, Jia H, et al. “On the role of length of stay in healthcare-associated bloodstream infection.” Infect Control Hosp Epidemiol. 2012 Dec;33(12):1213-8. doi: 10.1086/668422. Epub 2012 Oct 19.
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