Does Outpatient IV Infusion Center Make Sense for your Rural Hospital?

We recently hosted a webinar, “Outpatient IV Infusion Therapy: The Highest ROI to Hit Rural America Since the Plow!” A guest on this webinar was Tim Thomas, who is currently a healthcare consultant. Tim has about 35 years of healthcare financial management experience, coming from serving as a rural hospital CFO and CEO, in addition to project management roles.

Community Infusion Solutions CEO Mitchell Berenson interviewed Tim during the webinar. The insights Tim shared are summarized here.

Mitchell: What was the situation at the hospitals you’ve led before you implemented an outpatient IV infusion center using the Community Infusion Solutions service model?

Tim: Generally, infusions were done in the emergency room setting. Sometimes, some IV therapy is done in the clinics as well. None of it is a structured, separate, service line. It’s generally a service that the emergency room department or the clinic is somewhat compelled into doing. Generally, they’d prefer not to. I think they would get a doctor’s order and then they were stuck with doing it. And there were not a lot of systematic procedures in place to handle infusion patients. Because of that, to a certain extent, the quality of service is lacking and, more importantly, the case management and the reimbursement elements to get properly paid are missing as well.

When you look at infusion programs, most of the hospitals do not look favorably on them in terms of where they’re at with their infusion program. I specifically ran into that at one hospital where we had an infectious diseases doctor in a tertiary market next to us that was seeing a lot of patients. He was ordering a lot of infusions for patients in our community and we just simply were not able to handle them, or if we did, we were doing a poor job of it. We tried to implement an expanded infusion program to accommodate that specialty physician’s referrals, and basically, just had to acknowledge after a while that we really weren’t able to handle those infusions in our community. He was also in agreement with that because of the quality. Our patients had to continue to go to that tertiary market to get infusions.

Mitchell: What led you to implement the Community Infusion Solutions service model, and what changed when you did?

Tim: I ran into Mitchell and Community Infusion Solutions at a conference where he was marketing an outpatient infusion program. And jokingly, I said, “Well, I’m not sure how you do that because we tried and we couldn’t get it to work!” And he said, “Well, we have been successful at it if you’re interested in giving a try.” I said, “Sure!”

It was a no-risk evaluation on our part. Mitchell did all the analysis. Frankly, I was not expecting a whole lot of success in doing it, but he put the program together and we implemented it. The implementation cost was minimal. All we had to do was buy a few infusion chairs and we took an existing patient room and converted it. We were on our way and were just incredibly successful with it. Within three months, we were generating $75,000 to $100,000 in collections. Our expense was less than half of that. That was the beginning of a very successful program with Community Infusion Solutions that currently is still in place.

Mitchell: How did the infusion center you created using our service model impact referrals and the hospital’s growth?

Tim: Once the specialty providers knew that we had an infusion program, they saw us as a referral outlet for them and for their patients that lived in our markets. They would continually evaluate whether or not we had other programs, asking us if we did this, or if that. Once they built a relationship with us, we were able to communicate our full array of services. We started getting referrals for wound care, pain management, and just other services in general.

Mitchell: What advice would you offer a rural hospital administrator who is skeptical or uncertain about whether an outpatient IV infusion center would work in their market?

Tim: Community Infusion Solutions does provide those Level 1 and Level 2 analyses, which, of course, are projections. This gives you a basis to go forward. A lot of times when you’re opening a new service line in a rural hospital, you don’t even have that: it’s best guess. Secondly, it is a minimal initial investment. Generally, if you’ve got a patient room available and you can put a couple of IV chairs in there, you’ve already got IV pumps, you’ve already got nursing staff. You really can get into an infusion program very, very inexpensively.

The only significant amount is the implementation fee that is required from CIS. But even that is very moderate compared to investing in other types of service lines. And most service lines require expensive equipment or multiple levels of labor resources and so forth. I think the simplicity of the infusion program makes it an excellent opportunity for a hospital to evaluate, investigate, and hopefully implement to see if it’ll work in their hospital.

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