Outcomes prove value

Friday, January 22, 2016

SAN ANTONIO – Although it may seem like a no-brainer that patients who receive infusion therapy at home fare better—and at less cost—than other patients, providers need hard data to make their case to payers, says Paul Mastrapa.

“It’s difficult to quantify what really are the cost savings,” said Mastrapa, CEO of Option Care, which recently published a study on outcomes. “The industry really hasn’t done a good job of that.”

According to the study, patients receiving in-home immunoglobulin therapy with high levels of clinical oversight from Option Care found that overall costs per year for those patients were $112,700 vs. $120,500 for patients from the control group. 

Those patients also had fewer infections and fewer serious adverse events.

“In my mind, what the study highlights is, there is a tremendous amount of value in a clinician having eyes on the patient,” said Mastrapa. “You can’t underestimate that. The more engagement you can have efficiently with the patients, especially for a high-cost patient, the more value you can unlock within the system.”

As the healthcare system migrates from a fee-for-service model to what Mastrapa describes as a “more strategic” reimbursement model that pays more for value-added care than activity, providers across the healthcare continuum are going to need data to play in that world.

“I’d love to have a nurse at every bedside but that isn’t feasible,” he said. “Unless you can demonstrate the value of what you are doing, you aren’t going to get paid. We have to challenge ourselves with what’s the right level of care, and how do we leverage technology to meet the clinical and outcome objectives at the most affordable price.”