Take aim at MCOs with ambulatory infusion sites
Take aim at MCOs with ambulatory infusion sites
Sites diversify services mix for marketing
How would you like to triple staff productivity, expand the range of services you provide, and increase your marketability to any payer source or care provider participating in at-risk contracts? Option Care of Cincinnati achieved all of this when it set up ambulatory care sites covering metropolitan Cincinnati.
Ambulatory care centers are proving to be the answer to numerous woes plaguing home infusion agencies. Ron Ferguson, RPh, the director of market development for Option Care, tells Home Infusion Therapy Management that he anticipates such sites to provide his agency with exceptional growth in the future. It wasn’t just an expansion of services that prompted Option Care to open the sites. Other benefits were realized as well, Ferguson says. They included:
• Lower costs.
Ferguson says the savings you’ll realize in setting up an ambulatory care/alternate infusion site won’t result from services provided. Instead, savings will come from the increased number of patients a nurse can see in an alternate site as opposed to traveling from home to home. Option Care’s nurses who moved from home infusion to ambulatory care sites now see 10 to 15 patients each day instead of the usual five.
"Almost half our costs are in personnel, and we were looking for ways to lower our costs in terms of nursing services," he says. "Our nurses had a lot of drive time, and if you cut that out, you triple a nurse’s efficiency."
• Attract MCOs.
Any payer source or at-risk provider of health care services finds alternate site care settings such as ambulatory care sites attractive alternatives to home care, including home infusion, Ferguson says.
"We are able to reduce the cost of our nursing visits by 50% and our per diem by 20%, and we pass the lower cost to them. The marketing process has mainly been approaching managed care organizations and telling them we can help lower their costs. We’re in the trial stage as to whether managed care will take hold of the concept, and so far the response has been favorable," he says.
Option Care has four ambulatory care centers, two of which opened within the past three months. To make its services as convenient as possible for MCO patients, the company plans to open more sites.
"We want to make it convenient for patient needs," Ferguson says. "We’re working toward having a site within 10 minutes of patients’ homes. We need a couple more sites to have coverage of Greater Cincinnati."
Cincinnati’s ambulatory care sites have benefited from being stand-alone centers, Ferguson says.
"We’re not associated with a hospital in any way. We’re company-owned. The advantage of being independently run is that there are no political ties to certain physician groups giving referrals, or if it’s a competing hospital, they may be reluctant to send their patient to a center that is affiliated with another hospital system," he says.
This ties in with Option Care’s ultimate goal of marketing the sites to physicians and hospitals that have signed at-risk contracts. By being a non-affiliated entity, Option Care can market itself to any potential client. Option Care is increasing its potential market further by offering much more than infusion services.
"We really want to promote this for whatever type of care patients are getting," he says, whether it be infusion or unrelated nursing services such as wound care.
Option Care is offering the sites as an addendum to existing contracts with MCOs and passing on the savings. However, the sites could allow Option Care to provide services to patients of MCOs with which it does not have contracts. If another infusion agency has an existing contract with an MCO but does not offer ambulatory care, Option Care would offer an ambulatory-care-site-only contract and later try to expand the contract.
"The goal would be to show the payer good service and good care at the sites, then approach them and ask if they’ll give us a try in the home care setting," says Ferguson.
Most any IV therapy done in the home is a candidate for ambulatory care sites. Ferguson notes that in some instances, the alternate site is preferable. For example, physicians often prefer that a blood transfusion be done in the controlled setting of an Option Care ambulatory site than in the home. And physicians aren’t the only ones who prefer the ambulatory care sites. Some patients who receive antibiotic infusions lasting several hours prefer the sites as well.
"We’ve had a few patients that have switched," says Ferguson. "If they’re getting a four- to six-hour infusion in the home, once you’ve set up the pump and pole, it can disrupt home life. Once they’ve come in and received the care here, they’ve actually liked it better."
For now, staff is made available on a schedule-only basis.
"We’ll provide 24-hour service," says Ferguson. "If someone needs service at 2 a.m., we’ll be there."
Hopes are that the sites prove successful enough that each can be staffed 24 hours a day for walk-in care.
Don’t think it costs an arm and a leg to set up an ambulatory care site. Ferguson says the equipment needed is minimal. He adds that it may be better to rent a small space and expand in the same building or a nearby office once you need more space.
"We rent the space, and it’s not hard to set up because the equipment required is basically a chair, pole, TV with VCR for longer-term infusions, and a comfortable place for the patient to be."
There’s no need for a pharmacy, because all four sites are within a half hour from the Option Care pharmacy.
"We might be interested in an on-site pharmacy, but the volume would have to be tremendous," he says.
He doesn’t discount the possibility of setting up a site in the Cincinnati suburbs, however. Even a rural agency could benefit from establishing an alternate site, he says. For example, if an MCO has a contract with a large employer in the suburbs, that in itself could justify establishing an ambulatory care site nearby.
(Editor’s note: Next month, we’ll talk to Option Care about how it is preparing for its first ambulatory care site survey by the Joint Commission on the Accreditation of Healthcare Organizations, and we’ll feature some tips from the Joint Commission on problematic areas in those surveys.)
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