HealthPartners recognized for providing more choices at lower costs for infusions

Early results show $15,000 lower annual costs per patient

MINNEAPOLIS, Minn. – HealthPartners is being recognized for a program that provides infusions for biologic medications in a patient’s home, clinics or other lower cost sites. The program was one of just eight to receive an Excellence Award from the Pharmacy Benefit Management Institute at its annual conference on March 6. HealthPartners program was the only winner in the cost containment category.

Infusion therapy involves delivering medication through a needle inserted into a vein. It is needed for serious conditions that cannot be treated with oral medications, or when oral medications have failed. These conditions include rheumatoid arthritis, Crohn’s Disease, ulcerative colitis, psoriasis and rare genetic disorders. The procedure is often done in a hospital. However, it can be safely done in clinics or in a patient’s home. About 2,000 HealthPartners members receive infusions every year for drugs in the program. The cost of infusion therapy is often two to four times higher at a hospital than it is at a clinic or patient’s home.

HealthPartners implemented a pilot program in 2015 to offer alternative care sites to members who were getting infusions at a high-cost hospitals.

Based on the success of this program, HealthPartners began requiring the use of cost-effective sites of care in 2017 for common injectable drugs. One example is Remicade which is used to treat rheumatoid arthritis and other inflammatory diseases. Members could choose to get an infusion at a clinic, their home, or lower-cost hospitals.

To ensure that patients do not experience a disruption in care, HealthPartners member service specialists, pharmacy and nurse navigators, help members make the transition. The same navigator works with members throughout their treatment. This helps ensure that members have the support needed for a smooth transition if they moved from a hospital to a new setting. However, 74 hospitals chose to remain in the program by lowering their prices. As a result, more than half of members were able to continue their care in a hospital but at a lower cost.

Results

In the first six months of the program, costs fell by an average of $7,500 per member. The Site of Care program continues to grow; 44 drugs are included in the program in 2018, up from 39 drugs in 2017.