by Lisa Scholz, PharmD, MBA, FACHE, Senior Vice President Industry Relations
May 10, 2023
We’ve written before about the benefits of contracting with a specialty pharmacy for your 340B program, but you may not know that our compliance software can also manage split billing for the growing home infusion services segment.
A fast-growing market
Commonly used to administer specialty drugs. long-term antibiotic therapies and biologics, among other medications, home infusion is rapidly growing in popularity. It’s a $19 billion industry that has grown by 300% over a decade and serves 3.2 million patients annually, according to the National Home Infusion Association.
Home infusion has become popular as a less expensive way to administer infusion drugs in an outpatient, post-acute environment. It gained further momentum during the height of the COVID-19 pandemic, when hospitals were at capacity with acutely ill patients, making home care services a safer option. Many patients also prefer to receive the service in their homes rather than having to visit an outpatient infusion center to receive long-term therapy.
Given the many financial challenges in healthcare and 340B today, home infusion can be a good way to expand your 340B program benefits.
Home infusion split billing and compliance
Sentrex, The Craneware Group’s 340B contract pharmacy application, can manage not only retail sites and specialty pharmacies, but now home infusion programs. We support customers that provide home infusion for their patients through a contract pharmacy partnership with a specialty pharmacy when a covered entity may not have the resources or access to provide services in the home directly to their patient population using 340B.
To manage 340B compliance using Sentrex, home infusion providers must work with The Craneware Group’s implementation team on a simple customized setup and be able to support direct claims, avoiding the use of a third-party switch and associated fees. We use the replenishment model, meaning final dispensations, with no returned drugs and little need to reverse or reconcile any denied claims.
The specialty pharmacy is empowered to manage its own formulary of products. In addition to supporting the covered entity’s relationship with the contracted specialty pharmacy offering home infusion, Sentrex is versatile to process:
- Compounded drugs
- Medical claims
- Pharmacy claims
If you’re interested in learning how The Craneware Group can support your contracted home infusion program, contact us today.
If you’d like to continue the conversation with me, schedule a time that works for you and I’ll be in touch!