In 2024, we expect pharmacy-based ambulatory infusion suites (AIS) to become a crucial way for health systems to successfully address the growing need for infusion capacity and site of care (SOC) challenges while supporting nursing efficiency. Let’s explore the pharmacy-based AIS world and the essential coordination strategy across multiple SOCs that organizations should focus on in the coming year.
Definition and Nomenclature Challenges
Infusion services occur in various alternate SOC settings, including physician offices, freestanding infusion clinics or home infusion. Pharmacy-based AIS, a newer development, stems from the expansion of home infusion services and expands the offerings of home infusion providers. The National Home Infusion Association (NHIA) defines pharmacy-based AIS as a setting where clinical care is provided under a physician’s orders, with the pharmacy as the billing provider. In other words, the pharmacy-based AIS serves as a hybrid between home infusion billing and an infusion-clinic “lite” setting.
Competition from Outside Firms
Increased competition from for-profit entities entering the alternate site infusion field poses another challenge to health systems. It’s necessary to understand strategic investments by private equity firms to reveal the evolving nature of pharmacy infusion services and an identified area of opportunity for these businesses. A strong organizational infusion strategy is vital to prevent unnecessary loss of services to outside competitors.
Integral Role in the Continuum of Care
Pharmacy-based ambulatory infusion suites are pivotal in health systems’ pharmacy continuum of care. Health systems can seamlessly address challenges due to the shift from hospital-based centers to outpatient settings while offering more efficient nursing workflows. Additionally, organizations will need multiple service levels to provide care as new medications come to market with various administration methodologies and payer benefit management practices.
Central Prior Authorization Opportunities
As payers increasingly focus on high-cost drug products, managing and coordinating SOC becomes an important theme for organizations. It will be critical for organizations to prioritize centralized prior authorization of all medication services through pharmacy to help navigate appropriate options. This will create efficiencies, remove administrative burdens from clinic staff, and help reduce infusion service leakage to competitors. Central prior authorization is the “easy button” for your healthcare providers!
Cost-Effective Buildout and Examples
At Visante, we work with a wide variety of organizations to support alternate site infusion services. Organizations are often surprised to learn that these suites are relatively low-cost to build. Identifying unutilized space within organizations allows for cost-effective development and repurposing. We especially see opportunities following the COVID-19 pandemic, including administrative spaces vacated due to remote work or spaces leveraged for COVID-19 therapies but no longer used. Listen to our podcast The Infusion Market is Evolving – Are You Ready? to learn how the University of Maryland established an infusion suite.
Empowering Health System Leaders: A Coordinated Approach
Implementing home infusion and AIS services is a valuable move for decision-makers. Clear articulation of SOC challenges to stakeholders, collaboration with senior leadership, and engagement with prior authorization teams are imperative. A coordinated approach across multiple SOCs, including hospitals, offices, pharmacy-based infusion suites, home infusion, and specialty pharmacy, ensures seamless patient transitions and optimized resource utilization.
In conclusion, the rise of multiple infusion SOCs continues to be a transformative phase in managing patient pharmacy services within health systems. For health system leaders exploring healthcare innovations, it will be critical to embrace pharmacy-based infusion services and adopt a system infusion strategy to drive future success.
To learn more, read our full summary of the top 10 issues facing health system pharmacy in 2024.
At Visante, we help health systems accelerate strong financial and operational performance through pharmacy. Learn more here about our Infusion Services and Optimization. Our team’s expertise and innovative approach can help you optimize your fully integrated health system pharmacy program. Email email@example.com or call (866) 388-7583 to speak to one of our team members.