How Misaligned Policy in 21st Century Cures Will Hurt Home Infusion Providers

Signing of the 21^st Century Cures Act was a watershed moment in healthcare. But buried deep within the law are two provisions that are severely harming providers of home infusion services.

In the law, Congress changed the way home infusion providers are paid, reducing reimbursement for the infused drugs, while also including a new payment for professional services associated with providing home infusion treatments. But these cuts take effect immediately, while the new payments don’t kick in until 2021, creating a four-year gap of economic hardship for home infusion providers.

According to a new survey from Innovatix, a Premier Inc. company, this four-year gap is having negative consequences on providers and beneficiaries.

Specifically, home infusion provider survey respondents are saying the change will harm patient access to home care, potentially add expenses to healthcare and have a negative impact on business and jobs.

• 31% say the change in reimbursement will push them to stop accepting new Medicare beneficiaries
• 34% say they will be forced to discontinue services for existing patients
• 83% say the law is likely to push beneficiaries into other, higher cost settings for their care – settings that can cost 4 or more times as much as home care
• 92% say the effects of the payment change will be damaging or extremely damaging to their business
• 42% say they will be forced to eliminate good jobs in their pharmacy, including for pharmacists and nurses

A significant issue with this payment gap is that it will have the unintended consequence of limiting home infusion services and pushing patients into more expensive settings for their medications. Not only is this work counter to patient wishes, many of whom vastly prefer to receive services at home, it will make it that much harder for providers to achieve success in alternative payment models, such as bundling or shared savings, both of which are predicated on reducing total costs and directing care to lower cost, high quality settings.

At Premier, we’re working hard to ensure the 21^st Century Cures home infusion provisions are amended as quickly as possible, but it will require Congressional action to repair. Click here for more information.