By Kayla Green, Vizient
With the increasing shift of treatment from inpatient to outpatient settings, come questions about which medications can safely be used at alternate sites of care facilities within a health system. Fortunately, the Vizient Pharmacy Site of Care Database — recently released by Vizient Pharmacy Solutions — is looking to help answer those questions.
Historically, health systems have primarily provided ambulatory infusion services at hospital-affiliated outpatient clinics and used the system's pharmacy, but costs for these infusions are higher due to the around-the-clock nature of hospital care. And now — thanks to the changing healthcare landscape, payors are mandating the use of lower cost sites of care for outpatient infused medications and shifting certain infused medications and drug reimbursement to the pharmacy benefit.
"Outpatient volumes are expected to grow 16% over the next decade and shifts in care due to payer mandates could continue to influence that growth," said Shannon Holden, Vizient senior clinical manager, pharmacy. "Patients, too, are wanting to see more flexibility in their care and are opting for these venues, which means hospitals and healthcare providers need to get on board."
According to the Vizient Sites of Infusion Care Report, these payor shifts could bring an additional 25% growth in ambulatory surgery centers and 18% growth for physician offices and hospital outpatient units by 2032. And per the Home Infusion Market Report, the U.S. home infusion market — a $19 billion industry that serves 3.2 million patients annually — has experienced 300% growth over the past 10 years, with a projected annual growth of 7.9% through 2030.
"The remarkable growth in this area, particularly in specialty pharmaceuticals, makes it challenging for healthcare providers to maintain high quality patient care without a method to help them delineate which medications can be administered at an alternate site of care — whether that be hospital-based, at a physician's office or pharmacy suite, or home infusion," said Carina Dolan, associate vice president of clinical oncology, pharmacoeconomics and market insights at Vizient.
Solving for today's healthcare challenges
The Pharmacy Site of Care Database identifies key attributes of injectable medications, such as therapeutic class, administration recommendations and infusion times, among others, that can help physicians, nurses, pharmacists and other healthcare providers determine where the medication could be safely and appropriately administered.
The new database will be updated quarterly and offers providers the ability to search and review medications to further understand operational and clinical considerations that can assist in determining the appropriate site of care for a health system — whether that be hospital-based, a physician's office, an ambulatory infusion site, home infusion, or a pharmacy infusion suite.
The ever-evolving list currently includes 700 intravenous, intramuscular and subcutaneous injectable medications as well as Phase III pipeline medications, which are medications nearing the final trial stage and seeking FDA approval. Reimbursement components such as the HCPCS codes and CMS status indicators also are included with each medication, making it easy for healthcare organizations to determine which medications align with Medicare or Medicaid.
"It's very clear to us that the outpatient market will only continue to evolve and grow over the next decade, and it's our hope that this new database will help healthcare providers find the information they need to make informed decisions about their site of care strategy," Dolan said.
Learn more about the Vizient Pharmacy Site of Care Database.