Option Care Health, Inc. (‘Option Care Health’) provides home and alternate site infusion services.
The company services through its national network of various locations in multiple states. Option Care Health’s infusion services include the clinical management of infusion therapy, nursing support, and care coordination. Option Care Health’s multidisciplinary team of more than 5,000 clinicians, including pharmacists, pharmacy technicians, nurses, and dietitians, are able to provide infusion ser...
Option Care Health, Inc. (‘Option Care Health’) provides home and alternate site infusion services.
The company services through its national network of various locations in multiple states. Option Care Health’s infusion services include the clinical management of infusion therapy, nursing support, and care coordination. Option Care Health’s multidisciplinary team of more than 5,000 clinicians, including pharmacists, pharmacy technicians, nurses, and dietitians, are able to provide infusion service coverage for nearly all patients across the United States (‘U.S.’) needing treatment for complex and chronic medical conditions.
Option Care Health contracts with managed care organizations, third-party payers, hospitals, physicians, and other referral sources to provide pharmaceuticals and complex compounded solutions to patients for intravenous delivery in the patients’ homes, or other nonhospital settings. The company’s services are provided in coordination with, and under the direction of, the patient’s physician. The company’s multidisciplinary team of clinicians, including pharmacists, nurses, dietitians, and respiratory therapists, work with the physician to develop a plan of care suited to each patient’s specific needs. The company provides home infusion services consisting of anti-infectives, nutrition support, chronic inflammatory disorders, neurological disorders, immunoglobulin therapy, and other therapies for chronic and acute conditions. The company operates in one segment, infusion services.
The company’s operating model enables it to provide favorable outcomes to its stakeholders as follows:
Patients: The company improves patients’ quality of life by allowing them to receive infusion therapy at home, or at one of its ambulatory infusion suites. In addition, the company helps manage patients’ conditions through counseling and education regarding their treatment, and by providing ongoing monitoring to encourage patient compliance with the prescribed therapy. The company also provides services to help patients receive reimbursement benefits.
Payers: The company provides payers with a comprehensive approach to meeting their pharmacy service needs, and providing solution. The company’s provision of infusion pharmacy services in the patient’s home, or at one of its local ambulatory infusion suites offers an alternative to providing these therapies in a hospital setting. The company also provides payers with utilization and outcome data to evaluate therapy effectiveness.
Providers: The company provides providers with timely patient clinical support by providing care management related to their patients’ pharmacy needs, and improving compliance with therapy protocols. The company eliminates the need for providers to carry inventories of high-cost prescriptions by distributing the medications directly to patients’ homes.
Pharmaceutical Manufacturers: The company collaborates with pharmaceutical manufacturers to provide a broad distribution channel for their existing pharmaceuticals, and their new product launches. The company implements patient monitoring programs that encourage compliance with the prescribed therapy. The company also provides valuable clinical information in the form of outcomes and compliance data to manufacturers to aid in their evaluation of the efficacy of their products.
Health Systems: The company partners with health systems across the country to provide seamless transitional care within an effective post-acute care network to manage patients across the continuum of care. The company assists partnered health systems in monitoring key metrics that tie back to what most payers monitor in their value-based contracts.
Services
The company provides home and alternate site infusion services. The company’s services are most typically provided in the patient’s home, but may also be provided at clinics, physicians’ offices, or ambulatory infusion suites. The company provides a broad therapy portfolio through its network of 92 full-service pharmacies and 93 stand-alone ambulatory infusion suites. The company’s home infusion services include medication and supplies for administration and use at home, or within one of its ambulatory infusion suites, consultation and education regarding the patient’s condition and the prescribed medication, nursing support, clinical monitoring and assistance in monitoring potential side effects, and assistance in obtaining reimbursement. The company administers a wide variety of therapies and services, including the following:
Anti-Infectives Infusion: The company provides comprehensive home infusion services to combat serious infections in patients of all ages. The company’s anti-infective therapy and services help avoid hospitalizations for many infections that can be safely treated at home.
Nutrition Support: The company delivers comprehensive nutrition support across pediatric, adult, and geriatric patients. The company’s expert team provides home parenteral nutrition and enteral nutrition support for numerous acute and chronic conditions negatively affecting nutritional status, such as stroke, cancer, and gastrointestinal diseases.
Immunoglobulin Infusion: The company offers expertise, access, and support in immunoglobulin (‘IG’) infusion therapy designed to treat immune deficiencies. Immune deficiencies are disorders that reduce the patient’s ability to identify and destroy substances that do not belong in the human body, and are characterized by reduced levels of antibodies. Intravenous IG infusions are concentrated antibodies that have been purified from large numbers of human blood donors.
Chronic Inflammatory Disorders: The company treats chronic inflammatory disorders, which include Crohn’s disease, plaque psoriasis, psoriatic arthritis, rheumatoid arthritis, ulcerative colitis, and other chronic inflammatory disorders.
Neurological Disorders: The company provides an array of treatments to manage the progression of neurological disorders, such as Duchenne Muscular Dystrophy, Multiple Sclerosis, Alzheimer’s Disease, and other neurological disorders.
Bleeding Disorders Infusion: As a provider of home infusion therapy for hemophilia and von Willebrand disease, the company streamlines the administrative burdens associated with infusion therapies for bleeding disorders. The company works with medical specialists across the country to offer access to all approved factor products, a full range of therapies, and dedicated support services.
Naven Health: The company offers a nationwide home infusion nursing network and clinical platform. Naven Health focuses on delivering highly specialized infusion care.
Women’s Health: The company offers therapies that women need to survive and thrive through high-risk pregnancies. Personalized programs in prematurity, nausea and vomiting hyperemesis, diabetes in pregnancy, and hypertension help meet the needs of each mother.
Heart Failure: The company administers home infusion services to treat heart failure, either in anticipation of cardiac transplant, or to provide palliation of heart failure symptoms.
Other: The company offers a range of other infusion therapies to treat a variety of conditions, including pain management, chemotherapy, and respiratory medication.
The company also provides nursing services to support the above therapies, consisting of its nursing team, and through its network of sub-contracted nursing agencies.
Sales and Marketing
The company’s sales structure is focused on maintaining and expanding its relationships with drug manufacturers to establish its position as a participating provider when they release new products. In addition, the company’s sales structure allows it to leverage its national managed care relationships to provide sales and contract pull-through by the company’s local field-based sales personnel. This cross-utilization enables the company to market its services to numerous sources of patient referrals, including physicians, hospital discharge planners, hospital personnel, Health Maintenance Organizations (‘HMOs’), and Preferred Provider Organizations (‘PPOs’).
Competition
The company’s competitors within the home infusion market include Optum Infusion Pharmacy (a unit of the United Healthcare Insurance Company), Coram CVS/specialty infusion services (a division of CVS Health), Amerita Specialty Pharmacy (a division of BrightSpring Health), KabaFusion, Soleo Health, Vital Care, and many smaller regional and local home infusion companies, ambulatory infusion centers, or specialty pharmacies, including Accredo, CVS Caremark, Optum Rx, and Orsini.
Intellectual Property
Option Care Health and its subsidiaries own a variety of trademarks, licenses, and service marks, including but not limited to: ‘Option Care Health’, ‘Option Care’, ‘Critical Care Systems’, ‘Clinical Specialties’, ‘BioScrip’, ‘BioScrip Infusion Services’, ‘HomeChoice Partners’, ‘InfuScience’, ‘InfusionCare’, ‘Infusion Partners’, ‘Infusion Solutions’, ‘New England Home Therapies’, ‘Professional Home Care Services’, ‘Wilcox Home Infusion’, ‘Home Solutions’, ‘Home Solutions Infusion Therapy’, ‘Naven Health’, ‘Naven Connect’, ‘Restore+ by Option Care Health’, ‘IG Complete+’, ‘Care Nav+ by Option Care Health’, ‘BioCure’, ‘DP Diabetes in Pregnancy Program’, ‘HP Hypertension in Pregnancy Program’, ‘NV Nausea and Vomiting Hyperemesis Program’, ‘PM Prematurity Program’, ‘Factor Ape’, as well as several others.
Billing & Significant Payers
The company generates most of its revenue from contracts with third-party payers, including managed care organizations, insurance companies, self-insured employers, Medicare, and Medicaid programs. Where permissible, the company bills patients for any amounts not reimbursed by third-party payers.
The company’s largest payer represented approximately 15% of its revenue for the year ended December 31, 2024. The company also provides services that are directly reimbursable through government healthcare programs, such as Medicare and state Medicaid programs. For the year ended December 31, 2024, approximately 12% of the company’s revenue was reimbursable through direct governmental programs, such as Medicare and Medicaid.
Governmental Regulation
The requirements imposed by the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’) are extensive, and the company has taken, and intends to continue to take, steps to ensure its policies and procedures are in material compliance with the applicable provisions.
The company materially complies with the Pharmacy Compounding Accreditation Board (‘PCAB’) Accreditation Standards for Sterile and Non-Sterile Pharmacy Compounding, and pursues accreditation from quality associations.
The Food and Drug Administration (‘FDA’) also regulates certain medical devices, such as infusion pumps, the company uses to provide its services.
In addition to the Ethics in Patient Referrals Law (‘Stark Law’), many of the states in which the company operates have comparable restrictions on the ability of physicians to refer patients for certain services to entities with which the company has a financial relationship. The company attempts to structure all of its business relationships with physicians to comply with the Stark Law and any applicable state self-referral laws.