I came across this interesting article on a study that shows chemo costs less in doctor’s offices.
Chemotherapy Treatment in Hospitals Costs 24% more than Treatment in Physician’s Offices
The study found that care for patients treated in a physician’s office is less expensive regardless of the length of the chemotherapy duration. The average chemotherapy treatment lasted 3.8 months for patients treated in a physician’s office versus 3.4 months for patients treated in a hospital outpatient setting. For chemotherapy therapy lasting only one month, patients treated in a hospital outpatient setting cost 28 percent more than patients managed in a physician’s office. For patients receiving a full 12 months of chemotherapy, hospital outpatient care costs 53 percent more than in the physician office-based setting. These results are adjusted for the effect of age, sex, and prior history of cancer, but do not reflect other patient acuity factors that could influence total costs of care.
Our study documents that chemotherapy treatment in an oncologist’s office costs less than in a hospital regardless of the length of treatment,” said Eric Hammelman, Avalere vice president and a study author. “At a time when the healthcare community is focused on managing costs, these findings show the importance of where care is delivered, and raise important questions about how best to manage cancer treatment.”
This is good news for the private payers and for the physician’s offices offering chemotherapy treatments. For the patients, there are certainly advantages to having treatments done at their physician’s offices. Most patients like the ‘cozy” environment with familiar faces and in certain places, free parking or infusion services conveniently and easily accessible is a plus. A lot of physician’s offices offering infusion services like chemotherapy or biologic infusions have designated an area in their offices for this purpose. Many have installed flat screen TV’s, free wi-fi , provide comfortable reclining chairs and delicious snacks. The infusion/chemotherapy services are provided by experienced and credentialed chemo/infusion registered nurses and the office is equipped with hoods for proper preparation of chemotherapy agents.
Aside from chemotherapy, infusion services at physician’s offices is growing because of the newer biologic agents indicated for autoimmune disorders like rheumatoid arthritis, psoriatic arthritis, gout, ulcerative colitis, Crohn’s disease, multiple sclerosis, to name a few. The study above focused on chemotherapy, but perhaps the same might be true for these non-chemo infusions, who knows.
I was glad to know that the cost to private insurance payers is less in doctor’s offices than the hospitals. This might encourage more patients to use the services at their physician’s offices. The question now is do the doctor’s offices make a profit? I would think they do in order to continue to provide this service to their patients. I don’t think they do this just because the patients prefer to come to their offices for infusions…. 🙂
Infusion Nurse Blog 
One of the reasons they can contain costs is that, at least in California, physician’s offices do not have any regulation. Their practices go unchecked. Not all physician offices employ experts in the field of infusion therapy or vascular access. We see some concerning things and hear some disturbing practices from the patients that end up being hospitalized. The oncology and infusion nurses have expressed their concerns to these physicians but it seems to fall on deaf ears. I don’t know of a way for patients to decide if their treatments are being delivered safely with no regulations in place.
There are regulations for physician’s offices-the same ones that apply to other healthcare settings. I agree that no one enforces or checks the offices for compliance (such as infection control, among others). In your state (CA), there are statements regarding medical assistants and IV therapy. Medical assistants are not allowed to perform such invasive procedures as: placing the needle or starting and disconnecting the infusion tube of an IV. administering medications or injections into the IV line. http://www.mbc.ca.gov/allied/medical_assistants_training.html
Although there are statements such as the above, there are still physicians who utilize untrained and unlicensed personnel to do IV therapy in their offices – which is a responsibility and a risk I hope they know they are taking.
Unfortunately, not all patients can identify the difference between an real”RN” and a medical assistant, who introduce themselves to patients as “nurse”.
Thank you for your comments.