The Rise of Home Infusion Therapy: Balancing Safety, Cost, and Patient Care

The Rise of Home Infusion Therapy: Balancing Safety, Cost, and Patient Care

Introduction:

Home infusion therapy has seen a significant rise in demand, driven by patient preferences, specialty drug availability, and workforce shortages. This practice allows health systems and specialty companies to administer prescription drugs intravenously in the comfort of a patient's home, avoiding overhead fees and reserving clinical space for acute cases. While payers tout potential cost savings, concerns about safety and cost considerations have emerged. In this article, we will explore the opportunities and challenges surrounding home infusion therapy and its implications for patient care.

The Growing Demand and Reimbursement Gaps:

According to estimates from the National Home Infusion Association, around 900 providers and 1,500 pharmacies offer home and specialty infusion therapy to 3.2 million patients annually. The expansion of Medicare coverage for home infusion therapy in 2021 has made it more accessible for patients. However, reimbursement gaps pose complications. Medicare per-diem rates do not always account for the rising costs of drugs and equipment, leading to financial challenges for the home infusion industry. Connie Sullivan, President and CEO of the National Home Infusion Association, highlights the difficulties faced by providers, including the need to cover all services, delivery costs, and overhead expenses within a bundled per-day payment.

Safety Concerns and Research Findings:

While home infusion therapy offers convenience and personalized care, questions regarding safety have been raised. The Centers for Medicare and Medicaid Services and the Leapfrog Group do not currently include data from home infusions in their quality reporting. However, a qualitative study conducted by CMS on intravenous immune globulin therapy showcased potential safety benefits. The study found that in-home therapy led to better treatment compliance, reduced risk of infection, improved infusion monitoring, and fewer missed doses. These findings suggest that with proper protocols and monitoring, home infusion therapy can provide a safe alternative to traditional clinical settings.

The Expansion of Home Infusion Therapy:

The potential for home infusion therapy extends beyond chronic disease treatments. So Yeon Kang, a doctoral candidate of health policy and management, predicts that insurers, consulting agencies, and tech companies may see home infusion as an attractive market. However, understanding all aspects of the business is crucial for success. Kang emphasizes the need for disruptor companies to navigate safety and regulatory concerns, including patient self-administration and proper drug storage during transit. As the definition of providers and payment policies become more flexible, there is a great opportunity for innovative companies to enter the home infusion market and improve patient care.

Partnerships for Whole-Person Care:

In line with the evolving landscape of healthcare, partnerships are being formed to enhance care for specific patient populations. Strive Health, a national leader in value-based kidney care, has partnered with Prominence Health Plan to provide high-quality, whole-person care for individuals with chronic kidney disease (CKD) and end-stage kidney disease (ESKD) in Nevada. This collaboration aims to address the unique needs of kidney patients and improve their overall well-being. Partnerships like these highlight the importance of comprehensive care models and the potential for integrated approaches in home infusion therapy.

Actionable Advice:

• 1. Ensure Proper Reimbursement: Advocacy for fair reimbursement rates that consider the rising costs of drugs, equipment, and services is crucial for the sustainability of home infusion therapy. Providers and industry associations should actively engage with payers and policymakers to address reimbursement gaps.

• 2. Prioritize Safety and Quality: Implement stringent protocols and monitoring mechanisms to ensure patient safety during home infusion therapy. Collaboration between healthcare providers, regulatory bodies, and technology companies can help establish standards and best practices for safe drug administration and storage.

• 3. Embrace Innovation and Partnerships: As the home infusion market expands, embracing innovation and forming strategic partnerships can enhance patient care and outcomes. Companies entering this market should have a comprehensive understanding of the industry, regulatory requirements, and the unique needs of patients to succeed.

Conclusion:

Home infusion therapy presents a promising opportunity to improve patient care, reduce costs, and enhance convenience. While challenges related to cost, reimbursement, and safety exist, the potential benefits are undeniable. By addressing these concerns through advocacy, research, and collaboration, the future of home infusion therapy can be shaped to prioritize patient safety, affordability, and overall well-being.