If you or someone you care for needs infusion therapy, you may have more than one option for where treatment takes place. Depending on the prescribed therapy, your clinical needs, insurance coverage, and your healthcare provider’s recommendation, infusion therapy may be provided at home, in an ambulatory infusion center, or in another outpatient or hospital-based setting.
So, how is the right setting determined?
There isn’t one answer for every patient. Understanding your infusion site-of-care options can help you have a more informed conversation with your healthcare provider and know what to expect as you begin treatment.
What Is Infusion Therapy?
Infusion therapy is a way of administering prescribed medications, fluids, or other therapies directly into the body. Depending on the treatment, an infusion may be delivered intravenously (IV), subcutaneously, or through another prescribed method.
Infusion therapy is used to treat a wide range of acute and chronic conditions. Depending on the medication and treatment plan, it may be a one-time treatment or continue on a recurring basis for weeks, months, or longer.
Just as treatment plans differ, so can the setting where infusion therapy is provided.
Where Can You Receive Infusion Therapy?
Common infusion settings include:
- Home infusion: Appropriate patients may receive prescribed infusion therapy at home with the medications, supplies, equipment, education, nursing services, and other clinical support needed for their individual treatment plan.
- Ambulatory infusion center: Patients visit an outpatient infusion center designed to provide infusion therapy in a clinical setting without being admitted to a hospital.
- Hospital outpatient infusion center: Infusion therapy is provided through an outpatient department affiliated with a hospital.
- Physician office or specialty practice: Certain therapies may be administered within a physician practice or specialty clinic.
The appropriate option depends on several factors, including the medication itself, how it must be administered and monitored, the patient’s health and individual circumstances, provider recommendations, insurance coverage, and the availability of appropriate infusion services.
What Is Home Infusion Therapy?
Home infusion therapy allows appropriate patients to receive certain prescribed infusion medications in their home.
Home infusion is more than simply having medication delivered. Depending on the therapy and the patient’s needs, services may include medication and supplies, specialized equipment, patient or caregiver education, nursing services, monitoring, and ongoing coordination with the prescribing healthcare provider. The Centers for Medicare & Medicaid Services (CMS) recognizes professional services, training and education, and monitoring among the services associated with qualifying home infusion therapy.
For some patients, receiving treatment at home can make recurring therapy easier to incorporate into everyday life by reducing the need to travel to an infusion facility.
However, not every medication or patient is appropriate for home infusion. The healthcare provider and infusion team consider factors such as the prescribed therapy, clinical needs, potential monitoring requirements, the home environment, and the patient’s or caregiver’s ability to participate in the treatment plan before determining whether home infusion is an appropriate option.
Patients or caregivers who will use infusion equipment at home should receive appropriate education and understand how to use the equipment, recognize potential problems, and know who to contact with questions or concerns.
What Is an Ambulatory Infusion Center?
An ambulatory infusion center (AIC) is an outpatient setting where patients receive prescribed infusion therapy without being admitted to a hospital.
Patients arrive for their scheduled treatment, receive their prescribed therapy with the clinical support and monitoring appropriate for their treatment plan, and typically return home afterward.
An ambulatory infusion center may be an option for patients who:
- Need or prefer an outpatient clinical setting
- Are not candidates for home infusion
- Require monitoring during treatment
- Prefer not to receive therapy at home
- Need a site of care that meets the requirements of their prescribed medication or insurance plan
The availability of AIC treatment depends on the specific therapy, patient needs, provider orders, insurance coverage, and other clinical considerations.
Home Infusion vs. an Infusion Center: Which Is Right for Me?
Neither setting is automatically the “better” choice. The goal is to identify an appropriate site of care for you and your prescribed therapy.
When evaluating your options, your healthcare provider and infusion team may consider:
Your prescribed medication. Some therapies can be administered in multiple settings, while others may require a particular level of clinical support or monitoring.
Your health and clinical needs. Your medical history, response to therapy, potential for reactions, and other individual considerations can affect where treatment is provided.
How often you need treatment. For patients receiving recurring therapy, travel time, treatment frequency, and scheduling may become important considerations.
Your home environment and support needs. When home infusion is being considered, the infusion team may assess whether treatment can be appropriately provided in the home and what nursing, education, equipment, or caregiver support may be needed.
Your insurance coverage. Health plans may have specific coverage requirements, provider networks, prior authorization requirements, or site-of-care policies. Coverage can vary by therapy and health plan.
Your preferences. When more than one clinically appropriate option is available, your lifestyle, schedule, comfort, and preferences may also be part of the conversation.
Who Decides Where My Infusion Takes Place?
Your prescribing healthcare provider plays an important role in determining your treatment plan and an appropriate site of care. Your infusion provider and health plan may also be involved in determining which options are clinically appropriate, covered, and available to you.
This is one reason coordination matters.
Before treatment begins, an infusion provider may work with your healthcare provider and health plan to review the prescription, verify benefits, obtain necessary authorization, coordinate medication and supplies, determine an appropriate site of care, and schedule treatment.
If you’re unsure why a particular infusion setting has been recommended, ask. Understanding your options can help you feel more prepared and involved in your care.
Questions to Ask About Your Infusion Site of Care
If you’re preparing to start infusion therapy, consider asking your healthcare provider or infusion team:
- Can my prescribed therapy be provided at home or in an outpatient infusion center?
- Why is this site of care being recommended for me?
- What type of monitoring will I need during my infusion?
- How long will each infusion take?
- How frequently will I need treatment?
- What should I expect before my first infusion?
- Does my insurance cover treatment in this setting?
- Will I need any special equipment or supplies?
- What education or training will I receive?
- Who should I contact if I have questions or concerns between treatments?
You don’t need to understand every detail of infusion therapy before getting started. Your healthcare and infusion teams can help you understand the process, prepare for treatment, and know who to contact when you have questions.
Finding the Right Setting for Your Infusion Therapy
Infusion therapy doesn’t always have to take place in a hospital. For appropriate patients and therapies, home infusion and ambulatory infusion centers can provide additional options for receiving prescribed treatment.
At Pyramids Infusion Services, we work with patients, healthcare providers, and health plans to help coordinate infusion therapy across home and outpatient settings. Our goal is to help make the process easier to navigate, from referral and benefits verification through treatment and ongoing support.
If you have questions about your infusion options, talk with your healthcare provider or contact our team to learn more about Home Infusion Services and Lotus Infusion Centers.
Sources
Centers for Medicare & Medicaid Services (CMS). Home Infusion Therapy/Home IVIG Services
U.S. Food & Drug Administration (FDA). Infusion Pumps: Tips for Using Your Pump at Home
MedlinePlus, U.S. National Library of Medicine. IV Treatment at Home
National Home Infusion Association (NHIA). About Home and Alternate Site Infusion
Individual treatment and site-of-care decisions are based on the prescribed therapy, clinical needs, provider recommendations, insurance coverage, and other patient-specific considerations. This information is provided for educational purposes and is not a substitute for medical advice, diagnosis, or treatment from your healthcare provider.