Perspectives

Hospital Systems’ Key Differentiator from Ambulatory Infusion Centers

Written by CPS Specialty Pharmacy Team | Oct 12, 2021 11:25:44 AM

A shift in the infusion marketplace has been gaining momentum in recent years. Demand has spiked for new, outpatient ambulatory infusion centers (AIC), which are cropping up rapidly. Hospital systems are adversely impacted by payors mandating these discharged patients move to more cost-effective sites of care, rather than receiving infusions within the hospital network. But there are solutions to address this new dynamic. Hospitals that understand the driving forces of this shift can adapt with strategies that retain patients without jeopardizing the quality of care.

The prevalence of outpatient ambulatory infusion centers has been driven by three primary factors that hospital systems must address:

  1. Payor demand for cost-effective solutions. First and foremost, payors are demanding more cost-effective solutions. Infusion patients often require treatment over long periods of time, or throughout their lives, without the need for additional hospital services. In the eyes of the payor, this makes hospital treatments too costly when the same quality of care can be provided at an outpatient AIC.
  2. Growing number of approved infusion drugs. As more and more specialty infusion drugs are approved for a variety of common diseases, and additional patients turn to infusion therapy to manage illness, the demand for AICs will continue to grow. Increased demand will strain payors already feeling the pain of hospital costs.
  3. Lack of hospital capacity. Beyond the financial impact, hospital capacity is increasingly challenging; hospitals lack the physical space to manage infusion patients on a growing scale, with a limited number of seats and staff. And, the ongoing COVID pandemic underscores the capacity challenges posed by reliance on hospital networks for infusion care.

While these factors all appear to work against patient retention, hope is not lost! Cost and capacity concerns can both be brought in line with market requirements through strategic management and planning. And beyond that, hospitals maintain one key differentiator: the continuum of care. This cannot be replicated by AICs. Hospital systems maintain holistic patient history and data that is critical context for the successful administration and management of infusion treatments. The hospital system enables physicians, pharmacists, nurses, and other healthcare providers to work off the same page, which produces better quality of care and stronger outcomes.

With the right insight and expertise, hospitals can adopt strategies that address market pressures and maximize differentiators. CPS® VP of Specialty Infusion Services, Eugene Queener notes, “By partnering with CPS, hospitals have the support required to evaluate solutions and strategies that meet the needs of the payor community while keeping patients in the continuum of care.”