Editor’s Note: The following article by Barbara Rosenblum, Founder and CEO of Strategic Healthcare Programs, (SHP) was originally published in the Spring 2009 edition of the ACHC newsletter: Surveyor. SHP provides one of the nation's largest independent home infusion benchmarking databases. Utilizing the CPR+/SHP interface, your home infusion company can automate the process of obtaining clinical benchmarking data with measurements accepted by accrediting agencies.

Data are most helpful when they’re current and actionable, but it’s hard to resist the temptation to look backward as a new year begins, and benchmarks are the best tool for that job. SHP presents a home infusion year-in-review with industry benchmarks from 212 providers that range from large, non-profit, and hospital-based, to small, for-profit, and rural-based.

Pediatric patients comprised 19.82% of the SHP database; Adults between the ages of 18-65 comprised 58.24%; and those over 65 comprised 21.95%. Medicare participation has not changed much, despite Part D. Many providers are unable to service Part D patients since the benefit only covers drugs. The primary payer in the SHP database remains Commercial/Private Insurance, which has been the case for the 13 years that SHP has analyzed infusion data. In order, follow Contract with Managed Care, Medicare and Medicaid.

Payment issues likely drive the therapy-mix in home infusion, because we haven’t seen the distribution change much over the last few years. It will be interesting to see how the Medicare Part B bill will affect volume and types of therapies provided.

Most of the referrals made to home infusion providers come from hospital-based discharge planners or case managers, and community physicians. SNF’s accounted for only 3.43%.

Most therapies are administered in the home and the volume for ambulatory infusion centers (Outpatient Facility), at least among our clients, does not appear to have grown.

Most patients are admitted to home infusion symptomatic (73%) and 16% are also in bed for a portion of the day. Upon discharge, patients show a marked improvement, indicating that home infusion has positively impacted patient outcomes.

Unplanned hospitalizations continue to be a concern for all sectors of home care, and national statistics show that hospitalizations for patients cared for by home health agencies are on the rise, despite focused efforts at reduction.

The national hospitalization rate for home infusion is 0.58% per 1,000 days of service, which is a decrease from the previous year. Most hospitalizations are a result of clinical decline, not a result of therapy-related events. In comparison, the hospitalization rate for home health agencies increased by a few percentage points.

The types of therapy-events most often reported are Missed Dose, followed by Adverse Drug Reactions. Most ADR’s reports are not severe nor do they lead to hospitalizations.

When untoward catheter-related events occur, they are most often associated with PICC and Midline catheters, followed by epidural lines.

Patients are extremely satisfied with the care and service received from home infusion providers, and rates have increased over the past three years. From the following chart, question # 12 is a “Net Promoter” question, meaning it is most indicative of the patient’s satisfaction, has also risen.

Strategic Healthcare Programs (SHP) is based in Santa Barbara, California, and provides decision support, benchmarking, and patient satisfaction programs to the entire continuum of home care. Home Health, Hospice, Home Infusion, and HME.
www.SHPdata.com. 805-963-9446.

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