The pros and cons of home infusion

On the one hand, home infusions can reduce cost; on the other hand, there may be some safety issues. A Modern Healthcare article provides an overview:

Around 900 providers and 1,500 pharmacies offer home and specialty infusion therapy to 3.2 million patients annually, according to estimates from the National Home Infusion Association. Clinicians travel to patients’ homes to place intravenous lines and administer treatments, often for chemotherapy, antibiotics or nutrition purposes. Patients are then responsible for maintaining upkeep of the IV line and sometimes self-administering medication between clinician visits, with providers using remote monitoring technology to keep tabs on their physiological conditions.

As mentioned above, the key benefit is cost savings and patient convenience. The article even cites my FTI Consulting colleague Lisa O’Connor.

The practice translates to possible savings. In the home setting, providers don’t incur overhead costs, meaning no facility fees or ancillary service charges for which patients could be responsible down the line.

“There’s almost no more expensive way to get care than in a hospital-based facility,” said O’Connor.

However, not all health systems are sold on the approach. Cost savings may not be as much as previously thought.

ContinuumRx is moving away from its original home infusion business model to open more ambulatory infusion clinics with scheduled appointments across its three-state footprint. Nurses doing home visits average three to four patients a day, while those in the clinics average 20 patients over an eight-hour shift, Hartman said, balancing out any overhead costs. About 15% to 20% of ContinuumRx’s patients are treated in the clinics, he said.

Safety concerns are numerous:

Adverse effects, such as extravasation, or when the drug ends up outside of the vein, may not be noticed quickly enough and lead to serious—and costly—health complications. Patients can also encounter problems if infusion sites aren’t cleaned properly, or if they experience negative symptoms as a result of the treatment.

And even those who want to continue with home infusion often outsource it.

Given the capital and resources required, FTI Consulting’s O’Connor said some providers find it more operationally feasible to partner with third parties that already offer home infusion services, rather than attempting to stand up or expand their own operations. UVA Health, for example, turns to other companies when patients have out-of-network insurance or live in other states

In short, home infusion may be a good option for some, but not all patients and should be used judiciously.