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Toolkit

Resources to optimize infusion center business and operations

Managing an infusion center has never been easy, but it's becoming increasingly difficult due to a host of challenges, including new regulations, skyrocketing costs of drugs, and more complex patients. Use the resources on this page to tackle your biggest priorities.

 

Determine the best billing strategy

The financial advantage of billing as a hospital outpatient department (HOPD) is steadily deteriorating for infusion centers due to site neutrality, changes to the 340B drug pricing program, and private payers' site-of-care policies.

To help you determine the best billing strategy, our Infusion Center Billing Strategy Playbook walks you through five key steps.

Use these additional tools and guides to help:

 

Optimize your staffing model

To maximize productivity and improve patient experience, it’s important to have the right staffing mix in place. Use the following four steps to optimize your staffing structure:

1. Compare your current staffing mix to peer organizations. Use our Infusion Center Volumes, Staffing, and Operations Benchmark Generator to view benchmark data from more than 100 infusion centers. This tool allows you to slice and dice the data by various factors, including region, analytic case load, and type of institution, to compare your infusion center to your peers. You can also read our key insights from the benchmark data for chemo nurse, clinical trial nurse, advanced practitioner, clinical support staff, and pharmacy staffing from our infusion center benchmarking surveys.

2. Maximize the efficiency of your current staffing model. Ensure that your program can accommodate growing workloads and escalating treatment complexity with our Three-Step Cancer Staffing Makeover. And make the most of pharmacists' knowledge and skillset to help increase nurse and physician capacity.

3. Determine your current and future staffing needs. Use the Infusion Center Staffing Profiler to evaluate your current staffing in relation to your patient volumes and number of chairs, while anticipating how your staffing mix will need to change as your program grows.

4. Develop an acuity-based staffing model. Use our Acuity-Based Infusion Center Staffing Tool to identify patterns in patient volumes, scheduling, and acuity. The tool lets you analyze staffing levels and leverage data to support changes in nurse staffing.

 

Ensure timely patient throughput

With many moving parts and unpredictable patient needs, the infusion center is susceptible to delays and breakdowns. In addition, growing volumes and expanding treatment options mean that many infusion centers are running at or above capacity. We’ve mapped out our best practice resources to help you improve your infusion center throughput in three steps:

1. Find areas for improvement. See how well your infusion center compares to your peers on key timeliness of care and patient throughput measures using the Infusion Center Benchmark Generator.

2. Increase your infusion center capacity and reduce appointment wait times.

3. Improve infusion center scheduling

 

Create a financially sustainable infusion center

Rising drug prices, declining reimbursement, and increasing prior authorization requirements have left many cancer programs concerned about the financial health of their infusion centers. The following strategies are essential to ensure financial sustainability, while also improving the patient experience:

1. Make sure you're getting every dollar you're owed.

  • Understand financial performance and identify opportunities through financial reporting. To get started, download a sample denials report from Avera.
  • Review our survey data to understand how pharmacy leaders feel about infusion center revenue cycle and opportunities for improvement.
  • Use our survey data to benchmark your organization's experiences with revenue cycle for provider-administered drugs and identify opportunities to strengthen your revenue cycle processes.
  • Prior Authorization for Physician-Administered Drugs provides best practices for staffing, process redesign, improving information flow, and working with payers to reduce prior authorization requirements.
  • Finding the right staffing model for the prior authorization team can be particularly challenging. See how two organizations reorganized their teams and saw significant returns.

2. Mitigate the risk of increasingly expensive drugs.

Understand why programs are investing in clinical pathways and how they're implementing them:

See how Memorial Healthcare and others are working with pharmacy to better understand drug profitability.

As drug costs soar, organizations need to systematize how they assess drug "value." See how Mount Sinai and Christiana Care are starting these conversations.

Review our 2021 Oncology State of the Union for examples of how cancer programs can leverage partnerships with a variety of stakeholders to respond to increasing financial pressure from purchasers.

Health plans are increasingly requiring that provider-administered drugs be sourced from an external pharmacy, often referred to as "white bagging." Develop a comprehensive strategy to respond to white bagging requirements and minimize impacts on patient safety, logistics, and finances:

Monitor the home infusion landscape and assess whether developing a home infusion program could be an effective strategy for your organization to maintain continuity of care and minimize infusion revenue gaps in the face of increasing site-of-care pressure from payers:

3. Improve patient care and your bottom line through financial navigation.

With growing evidence that financial toxicity impacts patient quality of life and even survival, cancer programs must find a way to address patients' financial needs.

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