The Challenges of Home Infusion Therapy and Amtrak's High-Speed Acela Fleet

Ben H.

Hatched by Ben H.

Jul 10, 2023

4 min read


The Challenges of Home Infusion Therapy and Amtrak's High-Speed Acela Fleet


Home infusion therapy and Amtrak's high-speed Acela fleet are two distinct industries facing their own unique challenges. Home infusion therapy has seen a rise in popularity due to patient demand, specialty drug availability, and cost-saving potential. However, concerns about safety and reimbursement gaps have led to questions about its advantages. On the other hand, Amtrak's new Acela fleet, intended to revolutionize train travel, has been delayed due to the limitations of running on century-old tracks. Despite these challenges, both industries present opportunities for growth and improvement.

Home Infusion Therapy: Safety and Cost Considerations

Home infusion therapy has gained traction as a means to administer prescription drugs intravenously in a home setting. This allows health systems and specialty companies to bypass overhead fees and reserve clinical space for more acute cases. Payers also see the potential for cost savings. However, concerns have been raised about the safety and cost considerations of home infusion therapy.

Safety is a primary concern when it comes to home infusion therapy. While some research suggests that in-home therapy can lead to better treatment compliance, fewer missed doses, reduced risk of infection, and improved infusion monitoring, the Centers for Medicare and Medicaid Services and the Leapfrog Group do not include data from home infusions in their quality reporting. Addressing safety concerns and ensuring proper regulatory compliance will be crucial for the expansion of home infusion therapy.

Cost is another significant consideration. Reimbursement gaps, particularly with Medicare per-diem rates, pose complications for home infusion providers. The rising prices of drugs and equipment are not always accounted for in reimbursement rates, leading to financial challenges. To address this issue, it is essential to revisit reimbursement policies and ensure that providers are adequately compensated for their services.

Expanding Home Infusion Therapy Beyond Chronic Disease Treatments

Despite the challenges, home infusion therapy holds promise for expansion beyond chronic disease treatments. Post-acute care services could be incorporated into the home infusion model, providing patients with a convenient and cost-effective option for continued care. Insurers, consulting agencies, and tech companies may see this as an attractive market, but a comprehensive understanding of the industry will be necessary for success. Flexibility in defining providers and payment policies will play a crucial role in the growth of home infusion therapy.

Amtrak's Acela Fleet: Modern Trains on Century-Old Tracks

Amtrak's ambitious plan to replace its Acela express trains with a new $2 billion fleet has hit a significant setback. The new trains, manufactured by Alstom, were originally scheduled to begin service in 2021 but have been delayed until at least 2024 due to mandatory testing and the challenges posed by the old railroad tracks they must run on.

The core problem lies in the fact that the Acela trains share tracks with commuter and freight trains, unlike the purpose-built high-speed tracks in Europe and Asia. This limitation has caused frustration for Amtrak officials, as the delay hampers one of their largest-ever procurements and an upgrade to one of their most important brands.

Despite the setback, the new Acela fleet offers potential improvements in terms of a smoother ride and faster acceleration. While the top speed increase is only 10 miles per hour compared to the current units, the articulated design and faster acceleration will contribute to overall trip time reduction. Resolving the challenges of mandatory testing and finding solutions to the limitations of old railroad tracks will be crucial for the successful deployment of the Acela fleet.


Both home infusion therapy and Amtrak's Acela fleet face unique challenges that need to be addressed for their successful implementation. For home infusion therapy, ensuring safety, revisiting reimbursement policies, and exploring opportunities for expansion are crucial. As for Amtrak's Acela fleet, finding solutions to the limitations of century-old tracks and completing mandatory testing will be essential for its successful launch. Despite the obstacles, both industries offer opportunities for growth and improvement. By addressing the common concerns of safety, cost, and infrastructure, these industries can continue to evolve and provide better services to their respective customers.

Actionable Advice:

  • 1. For home infusion therapy providers: Advocate for fair reimbursement policies that account for rising drug and equipment costs. Engage in dialogue with payers and policymakers to ensure adequate compensation for the services provided.
  • 2. For regulatory bodies: Include home infusion data in quality reporting to gain a comprehensive understanding of the safety and efficacy of in-home treatments. This will help drive improvements and ensure patient well-being.
  • 3. For Amtrak and train infrastructure stakeholders: Prioritize the modernization of tracks and infrastructure to support the efficient operation of high-speed trains. Invest in research and development to find innovative solutions that minimize disruptions and delays.

Hatch New Ideas with Glasp AI 🐣

Glasp AI allows you to hatch new ideas based on your curated content. Let's curate and create with Glasp AI :)