Expanding Care, Empowering Patients: How Oncology Practices Can Diversify with Specialty Infusions

Infusion therapies have traditionally been associated with oncology treatment or inpatient hospital care, but there are many specialty intravenous (IV) drugs that can be safely administered in an outpatient setting. These drugs treat a wide range of chronic diseases, such as rheumatoid arthritis, multiple sclerosis, Crohn disease, osteoporosis, and anemia, as well as neurologic and gastrointestinal conditions.

With the surge of novel infusion therapies, many independent, community-based oncology practices are expanding their offerings to include infusion services for illnesses other than cancer. While this shift offers clear benefits, it requires careful evaluation of key factors before making such a move. This approach helps inform decisions about offering these services and ensures smooth implementation if adopted.

What Benefits Can Be Gained?

Adding specialty infusion services offers many advantages to patients and providers. Patients often require these infusions for other chronic conditions in addition to their oncology care, and receiving all treatments at one convenient location simplifies scheduling, administration, and billing. This ultimately makes obtaining the necessary care more convenient and less burdensome.

Patients are also treated in a familiar environment by staff they know and trust. This familiarity and confidence can reduce the stress and anxiety that often come with receiving a new infusion. Additionally, community cancer centers are close to home, whereas some infusion centers may require the patient to travel for treatment. This one-stop comprehensive care approach simplifies these treatments and can provide a better patient experience overall.

In addition to benefiting patients, diversifying infusion services also adds another source of revenue for community oncology practices. It also enhances staff expertise through exposure to new products and services. Finally, by offering treatments for other chronic diseases in one location, the practice increases its ability to deliver comprehensive, coordinated care that provides better oversight of patients’ total care plans.

What Key Factors Should Providers Consider?

There are several important issues oncology practices should closely examine when deciding whether to expand their infusion services, including the following:

• Is there unmet demand for infusion services? If referrals are delayed, referring physicians and patients may welcome another provider, but if the market is saturated and satisfaction is high, expansion into infusion services may not benefit patients or providers.
• Do market demographics support the need for additional providers? Chronic conditions requiring IV therapies are common in aging populations. If the elderly population is growing, there may be an opportunity to meet an increasing patient need.
• Does the geography of the market support the addition of another infusion provider? The needs in a rural/suburban region may be quite different from those in a metropolitan area.

Best Practices for Successfully Adding Specialty Infusion Services

Once a practice has completed its due diligence and decides to move forward with adding specialty infusion therapies to their infusion suite, there are some sound principles that can be utilized for guidance during planning and implementation. The first step is to form a task force to create the collaboration and buy-in needed from key members of the practice staff. This working group should include a physician champion, a practice administrator, a revenue cycle staff member, a front office lead, nursing and/or pharmacy staff, and a financial counselor. Working together, they should assess market opportunities, specify responsibilities, develop workflows and procedures, and educate staff. A clear timeline helps members focus on the planning process, which can take up to 6 months to complete.

Once the task force decides upon a formulary, the practice should always verify drug availability with their distributor, as not all medications requested by referring physicians may be accessible. This will eliminate any interruptions in therapy or potential negative experiences for patients. By establishing a limited formulary of economically viable drugs covered by Medicare and most payers, practices can streamline planning and enhance financial sustainability.

Developing a reliable process to ensure prior authorization is also critical, rather than leaving that responsibility to the referring physician. Securing prior authorization before scheduling appointments should be standard practice. It is vital for the clinic to control the approval process to avoid financial risk from non-covered or economically unfavorable drugs that could burden both the practice and the patient.

Various organizations and companies have expertise in infusion services, and practices should seek their advice if they lack confidence in their ability to successfully launch this type of offering. While adding infusion services is a complex process, it becomes much more manageable with expert guidance.

Is the Required Effort Really Worth It for Practices?

Oncology practices are ideally suited to provide specialty infusions, as they already have the necessary expertise and facilities to deliver these complex treatments. Adding comprehensive infusion services is challenging; however, with thorough planning, execution, and oversight, practices can gain a new revenue stream while also providing a valuable service to patients in their community.