NIH White Paper Brief
The Price of Place
The same therapy. The same patient. A dramatically different price.
Why employers can no longer ignore site-of-care costs.
Where a medication or infusion is administered can significantly affect what a health plan and its members pay—even when the therapy, dose and clinical objective remain the same. This NIH white paper brief examines where site-of-care visibility breaks down, what the emerging policy direction means for employers and how plan sponsors can evaluate clinically appropriate alternatives.
What You'll Learn
A clearer way to examine site-of-care costs
WHY LOCATION MATTERS
Understand why comparable treatments can produce significantly different costs depending on where and how care is delivered.
WHERE VISIBILITY BREAKS DOWN
See why provider-administered medications can fall between the medical benefit, pharmacy benefit and existing vendor responsibilities.
HOW EMPLOYERS CAN RESPOND
Explore a framework for identifying high-cost claims, evaluating clinically appropriate alternatives and validating the financial impact.
Developed for the stakeholders responsible for plan spend
This brief was developed for self-funded employers, benefits leaders, health plans, TPAs, PBMs, captives, consortiums, stop-loss partners and other advisors seeking greater visibility into high-cost specialty medications and infusion claims.