Survey: Home Infusion providers worry about impact of 21st Century Cures Act

AUSTIN, Texas — A new survey from Innovatix is highlighting concerns home infusion providers have as the 21st Cures Act enters its fifth month. Under the law, which was signed by President Barack Obama in December 2016, the payment structure for infusion drugs under Medicare Part B changed from an average wholesale price to an average sales price.

To compensate for this, the law includes a new Medicare payment for services that accompany home infusion treatments, but that doesn’t take effect until 2021, leaving 92% of home infusion providers surveyed saying they think the change to ASP will be damaging or severely damaging to their business. Thirty-one percent said the reimbursement change would likely push them to stop accepting new patients with Medicare benefits and 34% say they will be forced to discontinue home services for their existing patient population.

“As a result of the severe financial hardship imposed by the Cures Act, Medicare beneficiaries will find it much more difficult to access home infusion services, even though many of them prefer to receive care in the comfort of their own home, or are unable to travel to receive care,” Innovatix said in its results breakdown.

The survey found that 83% of respondents expected for the reimbursement shift to send patients to higher-cost facilities for their infusion, with Innovatix noting that it could be harmful to patient safety.

“Beneficiaries who are often susceptible to infection or other adverse clinical outcomes may now be forced to receive therapy in an institutional setting where they face greater risk of exposure,” the company said.

And beyond patient care, roughly 42% of respondents said they would be force to eliminate such jobs in their pharmacies as pharmacists and nurses, with 21% expecting job reductions of more than 21%.

“This policy change is having a devastating effect on home infusion providers, which many patients rely on to preserve their independence and quality of life,” Innovatix said. “Congress should act immediately to provide relief to pharmacies and ensure access to home infusion services for beneficiaries in 2018.”