Optimizing Infusion Site of Care: Unlocking Value for Payors by Putting Patients First

Specialty medications have transformed treatment for complex, chronic, and rare conditions. They have also created new challenges for patients and payors alike. Infusion therapies, in particular, are lifesaving but disruptive, and where they are delivered has profound implications not only on cost, but on patient safety, experience, and long-term outcomes.

That’s why site-of-care optimization is emerging as a strategic priority. The right infusion setting balances access and cost with a quality clinical experience and the economic sustainability of treatment.

Hospital-based infusions remain appropriate in certain high-acuity cases. Yet, for many patients, therapies can be administered just as safely—and more comfortably—in an ambulatory infusion center (AIC) or at home. These options provide convenience for patients while easing the financial burden for payors, often reducing costs by 50% to 87%.^{¹, ²}

Crucially, site-of-care optimization is not about shifting patients away from one setting for savings alone. It’s about asking, What’s the most appropriate setting for this patient’s full spectrum of care? When clinical appropriateness, patient preference, and sustainability align, outcomes improve for all stakeholders.

Why Site of Care Matters

For patients, the infusion site can shape every aspect of a therapeutic journey. A hospital outpatient center may be the right choice for highly complex cases, but many patients can be safely treated in an ambulatory infusion center (AIC) or even at home.

For example, some patients prefer the convenience of home therapy, reducing travel and exposure to hospital-acquired infections. Others may feel more confident in an AIC, where specialized nurses and pharmacists are highly involved in medication administration and the continuum of care. Both alternatives lessen the disruption of recurring hospital visits, improving adherence and satisfaction.

For payors and employers, the site of care directly impacts cost. Hospital outpatient settings often involve additional fees that, while appropriate in certain circumstances, may not always add value for every patient. Partnering with specialty infusion pharmacies (SIPs) enables payors to identify opportunities to redirect therapies to lower-cost settings—while safeguarding patient safety and outcomes.

A Patient-Centered Model for Specialty Infusion

Specialty infusion pharmacies like California Specialty Pharmacy (CSP), an Acelpa Health company, offer more than medication dispensing. They can streamline distribution, manage complex supply chains, and relieve providers of the burden of carrying costly inventories. At the same time, they create a framework where patient safety, experience, and outcomes are prioritized through personalized patient medication management programs.

CSP leads with one principle: site-of-care decisions should be made in the best interest of the patient. That means every site-of-care decision begins with data and ends with collaboration. We focus on:

• Data-driven identification. Working with payors, CSP analyzes utilization data to identify patients whose infusions may be appropriately delivered in an AIC or at home. Decisions are individualized—not generic—and account for each patient’s clinical profile and care history.
• Collaborative transition. CSP engages directly with physicians, payors, and patients to ensure that site-of-care decisions align with medical needs and personal preferences. Some patients may require the resources of a hospital-based center, while others thrive in lower-cost, patient-preferred settings.
• Integrated care teams. CSP’s pharmacists, nurses, and technicians remain actively involved, monitoring adherence, side effects, and outcomes in real time. This creates continuity across sites and ensures no patient ‘falls through the cracks.’

The result is not just lower cost—it is a smoother, safer patient journey.

Enhancing Outcomes Through Clinical Oversight

Site-of-care optimization is only effective if patients remain adherent and engaged. Specialty infusion pharmacies bring unique expertise to this challenge.

CSP’s pharmacists understand the complexities of specialty therapies—how medications interact in the body, how to manage side effects, and when to adjust treatment. Nurses provide high-touch support before, during, and after infusions, whether in the home or at an AIC. Together, they form a feedback loop, relaying insights to providers and payors so that care plans remain current and effective.

Technology strengthens this loop. CSP’s proprietary portal provides real-time visibility into prescription status upcoming administrations, and patient assessments. Providers and payors gain transparency into therapy progress, while patients stay informed and engaged. This visibility builds trust and allows for rapid intervention when needed.

The impact is measurable: CSP achieves adherence rates above 98%, reducing therapy gaps, avoidable hospitalizations, and emergency interventions—outcomes that matter to patients and payors alike.

Case in Point: Coordinated Care in Action

Consider a payor evaluating infusion utilization data. They identify a subset of members receiving recurring outpatient infusions at system-owned facilities. CSP partners with the payor to review the cases, assessing therapy type, acuity level, and geographic access to AICs or in-home services.

In collaboration with providers, CSP transitions appropriate patients to lower-cost sites. For these patients, the benefits are tangible: reduced travel, fewer unexpected fees, and consistent nurse support. For the payor, the shift generates measurable cost savings and improved member satisfaction scores.
This model is not hypothetical—it is a proven, data-driven approach that CSP implements with risk-bearing organizations today.

The Value Equation for Payors

For payors, the implications are clear:

• Lower total cost of care. Redirecting to AICs or the home can cut infusion costs by 50–87% for eligible patients, without compromising safety.
• Improved patient experience. Reduced lifestyle disruption, personalized nursing support, and digital transparency foster stronger engagement.
• Sustained outcomes. High adherence rates, clinical oversight, and proactive monitoring translate into fewer hospitalizations and complications.
• Strategic alignment. Site-of-care optimization demonstrates commitment to affordability and patient-centered value—a critical factor in employer and member retention.

The Road Ahead

Specialty drug spending will continue to grow, with infusion therapies at the center. What will evolve is where and how those therapies are delivered.

Forward-looking payors already view site-of-care optimization as a strategic imperative. The challenge is not whether to adopt alternative sites, but how to implement them without compromising quality or patient trust.

Specialty infusion pharmacies are uniquely positioned to help. By combining data analytics, clinical expertise, and collaborative partnerships, CSP ensures that each patient receives care in the most appropriate setting—every time.

Conclusion: A Shared Commitment

The future of infusion therapy will not be defined by cost alone. It will be defined by the ability to balance clinical appropriateness, patient preference, and economic sustainability in every care decision. Site-of-care optimization makes that balance possible.

For payors, the opportunity is clear: partner with specialty infusion pharmacies to deliver better care at lower cost, without losing sight of what matters most—the patient.

References

1. AHIP, “New Research Highlights Premium Impact of Provider Markups on Specialty Drugs,” April 18, 2024. https://www.ahip.org/news/press-releases/new-research-highlights-premium-impact-of-provider-markups-on-specialty-drugs

2. NHIF Infusion Journal, “Cost Savings: Home Versus Inpatient Infusion Therapy, A Review of the Literature,” Vol. 2, Issue 3, Nov./Dec. 2023. https://nhia.org/cost-savings-home-versus-inpatient-infusion-therapy/