When implemented well, a home infusion practice can be a strong complement to your current pharmacy offerings, allowing you to better serve your patients and grow your business. Home infusion is an important option for patients requiring both short- and long-term specialized therapy, as it allows them to get out of the hospital faster and is more cost-effective. With a growing aging population requiring more at-home services—and because the practice is widely covered by payers—home infusion represents a promising avenue to expand your existing pharmacy business.
That said, expansion into home infusion brings unique challenges, namely the complicated and often time-sensitive processes for which you will be responsible. Patients will rely on you to provide critical at-home treatment, from gathering care details from referral sources to delivering the right medications at the right time to filing insurance claims accurately and quickly. I hear many of the same challenges time and time again from home infusion providers: gaining and maintaining referral source relationships, handling workflows and billing processes efficiently and effectively and managing deliveries—all in the name of providing safe and reliable patient care.
Here are some of the most pressing challenges for home infusion providers, and how the right technology can solve these issues, support growth and improve patient care.
1. Creating Strong Referral Relationships
A post-acute care (PAC) provider’s business relies on the trust and partnership of referring providers. Those hospital and physician practices are looking for home infusion providers who not only provide high-quality service, but also are responsive and easy to work with.
Often, referral sources have to manually share patient information via fax or phone calls, requiring manual entry and maintenance on both sides and representing resources that could be deployed elsewhere. More often, referral sources are looking for PAC providers that can accept electronic referrals, which allow both parties to spend less time tracking down information and more time on patient care. In fact, in a MatrixCare/Brightree survey released in July 2019, 60% of referring providers said they would switch to a new PAC provider if that organization accepted electronic referrals.
With a statistic that high, it’s clear that interoperability—that is, the ability for electronic systems to communicate with each other—is no longer just an option, it’s a business necessity. Fortunately, technology providers have developed platforms focused on meeting the needs of both referring physicians and PAC providers. Adopting business software that enables seamless communication with your referral sources will strengthen your relationships, and in turn, help you stay competitive.
2. Managing New Referrals
The end of the work day tends to see a flood of new referrals as hospitals and physicians work to discharge patients. These referrals—which often come in with incomplete patient details—need to be handled in a timely fashion so the patient can move forward in their care journey. This means many PAC providers end up scrambling late in the day to get the information they need, often gathering it by hand from multiple parties if interoperable systems are not in place.
Fortunately, PAC-specific technology can completely automate the front-end process for receiving and inputting patient prescriptions, referrals and intake forms. This makes it a breeze for hospitals and physicians to send patients your way. Look for software through which electronic prescriptions are sent directly and securely from referring providers to pharmacies; that eliminates the back-and-forth of a manual prescription process and avoids documentation gaps.
Using electronic referral and prescription programs, PAC providers can also communicate securely and efficiently with prescribers at the beginning of a patient’s transition into PAC and throughout the treatment journey. The right platform allows prescribers and caregivers to work together to establish standard practices of care, as well as to tailor a multidisciplinary care plan to each patient’s unique needs and track outcomes along the way. In this way, technology can help support the highest possible levels of patient safety and treatment while also significantly improving efficiency.
3. Streamlining Revenue Cycle & Other Workflows
Building strong referral relationships and coordinating safe and effective patient care are essential for a home infusion practice but, of course, the work doesn’t end there. As a home infusion provider, you are responsible for managing many workflows—intake, pharmacy, deliveries, billing, collections—a multi-step, labor-intensive process when done by hand. Manual steps are costly and they delay getting treatment to the patients who need it.
According to a 2019 HomeCare magazine survey, cost was the number one barrier preventing home medical equipment providers from expanding into home infusion, with 56% of respondents saying they were not interested in adding the offering due to the overall expense. Taking that into consideration, and the high cost of infused medications, it is more important than ever to lean on smart technology solutions to help manage your business.
The right technology can create smooth-running operations and fast-growing revenues. Specifically, a strong revenue cycle management solution will streamline the billing and collections processes, improve days sales outstanding (DSO) and collection-to-billing ratios—and help you collect more, faster.
The right platform will also help you prioritize tasks by clearly configuring next steps with an owner and time frame, often resulting in dramatic improvements in DSO. Technology providers also offer work list capabilities for managing delivery tickets and determining which deliveries have been completed and are ready for billing. Increased efficiency reduces costs and headaches for both providers and patients. It allows you to spend less time on paperwork and claims and more time on treatment and care.
4. Tackling Unique Reimbursement Processes
Home infusion also requires specialized billing and reimbursement processes, presenting a learning curve for providers who are new to the space. Beyond hiring or consulting with personnel who are well-versed in home infusion, providers can look to technology to make billing processes function as smoothly as possible.
The right software will allow you to perform real-time checks of drug reimbursements before providing service, so you can give patients a clear understanding of their out-of-pocket expenses before moving forward with treatment. At the same time, proper technology tools will maximize revenue for your business by billing the right per diem reimbursement for every therapy, while making sure to bill for anything not included.
By billing items based on each payer’s unique requirements, choosing and utilizing the proper claim formats, technology can provide support for the more tedious aspects of the reimbursement process, saving you both time and resources.
5. Managing Deliveries
Finally, home infusion services have specific challenges around planning deliveries. Between compounded medications with a short stability window and time-sensitive patient needs, home infusion providers are required to carefully manage their patient deliveries. In many cases, this is a very manual process in which a small number of people hold the critical knowledge needed for operations, like which trucks need to go where, which orders need to be delivered first, etc.
A mobile delivery solution can simplify this process, automating each step in the workflow, from loading orders and patient data predelivery to documenting arrival and triggering billing. A GPS-based system also allows managers to monitor drivers in real time to improve transparency and ensure timely delivery.
The right technology can make everyone’s jobs easier and improve your business’s bottom line. One PAC provider saw drivers’ overtime hours decrease by 60% within six months of implementing a mobile delivery solution. On top of improved efficiency and productivity, the same company cut paper costs by more than 50% by switching to a digital platform.
To maximize the benefit you are getting from your technology provider, look for end-to-end solutions that flow into a central document management system, so you can access and integrate referral information, patient care plans, compliance and billing documents and delivery information all in one place.
Whether you currently offer home infusion as a part of your practice or are considering expanding into the space, facing these labor-intensive processes can feel overwhelming. However, the right technology can organize and streamline each step of the home infusion workflow, ensuring greater accuracy and freeing up time and resources that can be redirected towards providing high quality patient care.