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Learn more about OnePulse connect for healthcare practices
Learn how we can advance patient outcomes with innovative technology solutions
Implementing an in-office infusion program requires dedicated space, trained nursing staff, DSCSA-compliant drug procurement, payer credentialing, benefits verification workflows, and robust patient communication systems. Specialty practices can partner with a turnkey infusion services provider to handle these operational requirements. Practices that implement in-office infusion programs report improved patient adherence, up to 79%1, reduced referral leakage, and a new revenue stream through buy-and-bill reimbursement.
This guide is written for practice decision-makers evaluating whether to bring infusion services in-house:
In-office infusion addresses three core operational challenges: referral leakage (patients leaving the practice for infusions), care coordination gaps (fragmented communication between prescribing physicians and external infusion sites), and patient access delays (scheduling bottlenecks at external centers).
When practices cannot offer on-site infusion, patients are referred elsewhere. The practice loses visibility into treatment adherence, misses the revenue opportunity from drug margin and administration fees, and risks patients establishing relationships with other providers.
External infusion creates communication silos. The prescribing physician may not receive timely updates on infusion completion, adverse reactions, or patient concerns. Patients must coordinate between multiple facilities, increasing administrative burden and the risk of missed appointments.
External infusion centers often have limited availability, especially for longer infusions. Patients may wait weeks for appointments, disrupting treatment protocols. Some patients end up having to go to out-of-town infusion centers due to limited local options at times.
Patients consistently report three improvements when transitioning from external infusion centers to in-office infusion- at their trusted provider’s site of care: reduced logistical burden, more personalized attention from nursing staff, and reduced anxiety from having their physician nearby. These patient experience factors directly impact treatment adherence.
We interviewed patients at the Las Vegas Neurology Center after they transitioned from external infusion centers to the practice's OnePulse Connect-Infusion program, implemented and run by Elevate Health Technologies. Their feedback illustrates the tangible provider and patient benefits of in-office infusions.
Jim, a 49-year-old with multiple sclerosis who had been receiving infusions outside of the office, had recently moved and was driving to another state every 4-6 weeks for treatment because transitioning care took time. This is the perfect example of how other infusion sites of care contribute to a fragmented journey for patients.
"Getting everything switched over just took a really long time. Between work, which is super busy, and getting everything re-approved through a different practice... it just took a while."
Operational implication: Patients face significant friction when changing infusion sites. Practices that offer in-office infusion eliminate this barrier for their existing patients.
Another patient, Darla, a 63-year-old receiving IVIG for myasthenia gravis for 30 years, had been going to a large off-site infusion center. Her reaction to learning about in-office infusion:
"I was surprised and I was happy because it's convenient."
Darla contrasted her experience at a large infusion center with in-office infusion at her Neurology practice after the practice started doing infusions in their office:
"It was a big infusion suite. So you're not getting as much attention. They have to stretch themselves more, because there's a lot of people there. It just wasn't as pleasant as this experience is."
Operational implication: Staffing ratios matter. In-office infusion typically offers lower nurse-to-patient ratios than high-volume external centers, which patients notice and value. Often times the patient sees the same nurse which contributes to a better journey and outcomes.
For patients who experience side effects, having their physician nearby provides significant reassurance. Darla says:
"You have your doctor there in case something happens, because I get side effects sometimes. You know that they're in the same office space as you. That relieves my stress."
Operational implication: Physician oversight is a key differentiator. In-office infusion enables immediate clinical intervention when adverse reactions occur, without requiring separate appointments or facility transfers.
Darla described the difference she felt around her medical anxiety:
"I get anxious when I'm out of the house and it's a medical thing... but I don't have that there because I know I'm in good hands. This makes it easier and not so stressful."
Operational implication: Familiarity reduces no-shows. Patients who are anxious about infusions may be more likely to keep appointments when treatment occurs in a familiar environment with known staff.
Jim, as an experienced patient who had been on the same medication for years, appreciated being treated with respect:
"They treated me like somebody that's been on the medication, because I have been, but they also made sure I understood what was happening. It wasn't like, 'You've been on this drug a long time, right? Cool. Here's your infusion. Bye.'"
His overall assessment:
"The process overall was an easy process. They really try to make you feel comfortable, considering what you're there for. The process was, to me, very uncomplicated, which is important because of why I'm there."
A successful in-office infusion workflow includes seven steps: prescription receipt, benefits verification, drug procurement, patient scheduling/communication, infusion administration, physician oversight during treatment, and follow-up/monitoring. Each step involves specific roles and systems.
Understand 2026 drug pricing changes and buy-and-bill economics.
An in-office infusion program requires: dedicated physical space, trained nursing staff, DSCSA-compliant drug sourcing, payer credentialing, benefits verification capability, buy-and-bill billing infrastructure, and robus patient communication systems. A turnkey partner like Elevate Health Technologies’ OnePulse Connect-Infusion can provide all components.
Space Requirements & Comfortable Environment
Staffing Requirements
Compliance Requirements
Billing & Revenue Cycle Requirements
Technology & Communication
In-office infusion is most common in neurology, rheumatology, gastroenterology, dermatology, and oncology practices. Specialties that regularly prescribe biologic and immunoglobulin therapies. The specific medications and infusion durations vary by specialty.
Neurology: MS treatments (Tysabri, Ocrevus), IVIG for myasthenia gravis and CIDP. Infusion times range from 1 hour to 5+ hours.
Rheumatology: Biologic treatments for RA, lupus, psoriatic arthritis (Remicade, Orencia, Actemra). Infusion times typically 30 minutes to 3 hours.
Gastroenterology: IBD treatments (Remicade, Entyvio, Stelara). Often 1-3 hour infusions.
Dermatology: Severe psoriasis treatments. Lower volume than other specialties but growing.
Oncology: Chemotherapy and supportive infusions. Often requires more extensive infrastructure.
Elevate Health Technologies’ OnePulse Connect–Infusion utilizes our best-in-class technology as the backbone for our in-office infusion program; enabling your practice to streamline care, increase efficiencies, and enhance revenue.
The Las Vegas Neurology Center implemented OnePulse Connect - Infusion to bring exemplary infusion services within their neurology practice. The patients quoted in this article are recipients of that program, and their feedback reflects the operational and experiential benefits of a well-implemented in-office infusion solution.
How much does it cost to start an in-office infusion program?
Costs vary significantly based on existing infrastructure, patient volume, and whether the practice uses a turnkey partner. Key cost categories include space setup, staffing, technology, and compliance. Turnkey programs typically reduce upfront investment by providing staff and systems on a service model.
Can I start in-office infusion without hiring additional staff?
Yes, through a turnkey partner. OnePulse Connect-Infusion provides on-site infusion nurses as part of the program, eliminating the need for the practice to recruit, hire, and manage infusion nursing staff directly.
What is the difference between buy-and-bill and white bagging?
In buy-and-bill, the practice purchases the drug directly and bills the payer. In white bagging, a specialty pharmacy dispenses the drug and ships it to the practice, which then administers it and bills only for administration. Buy-and-bill typically offers better margins but requires more working capital.
How do I know if my payers will reimburse for in-office infusion?
Benefits verification confirms coverage for each patient. Most commercial payers and Medicare reimburse for physician-administered infusions. A turnkey partner typically handles payer credentialing and benefits verification as part of the program.
What happens if a patient has an adverse reaction during infusion?
In-office infusion provides immediate access to the prescribing physician, which is a key safety advantage over external infusion centers. Infusion nurses are trained in adverse reaction management, and practices maintain emergency supplies per protocol.
How long are typical infusion appointments?
Infusion duration depends on the medication. Some infusions (e.g., certain biologics) take 30-60 minutes. Others (e.g., IVIG, some MS treatments) may take 3-5 hours. Scheduling systems should accommodate varying appointment lengths.
Do I need special licensure to offer in-office infusion?
Requirements vary by state. Some states require specific facility licensure or pharmacy permits for drug storage. A turnkey partner typically handles compliance verification as part of implementation.
Can I offer in-office infusion for just one or two medications?
Yes. Many practices start with their highest-volume medications and expand over time. A turnkey program can scale with the practice's needs.
Schedule a consultative meeting with Elevate Health Technologies to learn how OnePulse Connect- Infusion can help your practice implement a turnkey infusion program, without the operational burden of building it yourself.
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Learn more about OnePulse Connect In-Office Infusion here.
About Elevate Health Technologies
Elevate Health Technologies is committed to making healthcare better for everyone. We collaborate with healthcare providers, patients, pharmaceutical manufacturers, and payers to deliver innovative technologies that truly make a difference.
OnePulse Connect empowers healthcare practices by optimizing efficiency and streamlining care, whether through buy-and-bill management, inventory tracking, medically integrated dispensing, or in-office infusion services. Our tailored approach delivers deep data insights, advanced analytics, and dynamic patient engagement platforms.
Together, we move as One Pulse, driving smarter, faster, and more connected health technologies for improved outcomes and better patient experiences.
Visit www.elevateht.com to learn more. Follow us on LinkedIn.
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