Reporter's notebook: Healthcare reform drives growth

Friday, June 19, 2015

Mention the Affordable Care Act to a roomful of HME providers and you’re likely to hear groans about higher costs for their businesses. Home infusion provider Paul Mastrapa, however, sees it as a growth driver.

“I put the ACA on the vein of increasing access for the previously uninsured,” said Mastrapa, CEO of Option Care, during a recent press call. “As access has increased, payers are more aggressively than ever looking at what is the right site of care for patients who require infusion therapy. That positions our services well to continue to be a value-added provider within health care.”

Infusion therapy provided in the hospital setting is roughly $1,500 per day, vs. $150 per day at home. In an outpatient setting, like an alternate infusion site, Option Care sees savings of anywhere from three to five times the cost, depending on location of care, says Mastrapa. Such savings will become increasingly important to the payers.

“We are seeing many of the plans, as they develop their healthcare exchanges, are aggressively looking for infusion providers in their network to ensure they have access to home infusion therapy due to the value proposition (we offer),” he said.

Although ACA was passed in 2010, it’s still early in the game to see if health plans will create incentives, such as reduced co-pays, to encourage patients to choose home infusion therapy, says Mastrapa. 

“We’ve been working with some of the larger regional and national plans who are looking at how to realign member incentives to drive that behavior,” he said. 

Currently, many plans are designed in a way that drives patients to higher-cost settings, says Mastrapa.