Names have been withheld to protect the privacy of members.
It happened all too often. He was forced to wake up early before school so he could head to the hospital for an infusion. His treatment would run late, and he missed school, causing his grades to slip, while his mother missed time at work.
The routine had become a normal way of life for him and his mother, so she began looking for alternatives, leading her to the Site of Care program, an initiative led by Blue Cross Blue Shield of Michigan. The program aims to make high-quality, convenient care available while managing the costs of some of the most expensive medications.
In an effort to address the disparity in cost between inpatient vs. at-home infusions, BCBSM began the Site of Care program in 2015. The program shifts infusions from outpatient hospitals to other locations, including ambulatory infusion therapy clinics, doctors’ offices and infusion therapy from the comfort of the patient’s own home. The program began with only a few eligible medications but is growing quickly. More medications are becoming available through the program each quarter.
“This is an amazing thing for us. Our family loves home infusion,” the boy’s mother said.
The changes save time and make the infusions more comfortable for her son. Before joining the program, her son was forced to wake up early for his hospital infusions and then spend 90 minutes getting to school from the hospital. The entire process took nearly four hours of his day. Now, he can get more rest and eat breakfast during his home infusion, while also missing less school.
WHAT IS INFUSION THERAPY?
Infusion therapy is a way to treat or manage the more than 600 medical conditions. It involved administering medication directly into the bloodstream to change or alter the immune system. BCBSM encourages those receiving infusions to receive their infusion therapy of certain medical drugs at home, a doctor’s office or a freestanding infusion center instead of in a hospital outpatient department.
The average cost for a hospital outpatient infusion is $9,600, while the average cost in other settings is only $4,500. The cost of infusion in sites other than an outpatient hospital is between 30-50% less. Since the program began five years ago, the program has saved $200 million in medical costs. The program not only saves money, but it also provides high-quality care in a convenient manner, eliminating transportation and parking hassles and the possibilities for exposure to illnesses for compromised patients.
Receiving the infusion from home lowers the risk of exposure to bacterial and viral infections that may be in hospitals and other facilities. Not only can infusion be done from the home safely, but blood work as well, and any medications or supplies are delivered directly to the patients.
PATIENTS SEEING THE BENEFIT
Those who are taking advantage of the program are seeing the benefit from this change as well. During the program’s pilot stage, no patients switched back to an outpatient setting and there were no ER visits related to infusion at home.
During home infusions, many people can get back to their day rather than spending so much time in the hospital. Those who join the program are finding they can get things done while receiving their infusions, such as eating a meal, reading a book and even working from home.
Another benefit for patients is the ability to see the same highly skilled nurse for every infusion, which helps them feel more comfortable and improves care. The nurse gains familiarity with the patient’s health care needs and treatment regimen and can work with the patient’s doctor to address any concerns.
For more information on the Site of Care program, visit bcbsmpharmacy.com.
Photo credit: Tempura