In this episode, Dylan McCabe and Reece Norris interview Brian Nyquist, MPH – Executive Director for the National Infusion Center Association (NICA). Hear how Brian Nyquist first got involved in the organization and what NICA is doing to improve patient access to infusion centers nationwide. Learn more how you and your team can get involved in advocating for patient access in your own practice infusion suite or infusion center.

WeInfuse podcast

Transcript: Learn how the advocate for patient access with Brian Nyquist, Executive Director of NICA

Dylan McCabe: Welcome to the WeInfuse Podcast, episode number three. Welcome to the WeInfuse Podcast. My name is Dylan McCabe, and each week we bring you a behind the scenes look at the infusion industry. Our whole goal here is to provide tips, tools, and a roadmap for those of you, whether you’re a provider or a nurse practitioner or anyone involved in the complex world of infusion therapy and I’m excited because today I’ve got two guests with me. One is the Co-Founder of WeInfuse Reece Norris and the other is Brian Nyquist who I’ve been telling you guys would be on the show for a couple of weeks now. So we’re excited. He’s here, we’re all together in Florida, and today we’re going to dig into issues involving infusion therapy. So let’s dive right in. Brian, thank you for being on the show, man.

Brian Nyquist: Thanks for having me.

Dylan McCabe: Reece, thanks for being on the show as well.

Reece Norris: Always a pleasure.

Dylan McCabe: All right. So we do have our special guests, Brian Nyquist, and the reason he’s special because he does things on a policy level and really pushes for best patient care issues, issues that really affect all of us, whether you’re a doctor or an office manager, whoever you might be working in a practice or a hospital, Brian’s really on the front lines of having, pushing for forth issues that affect us all. So it’s going to be great to have him on the show today. So Brian, I just kind of want to give you a second to kind of fill the background in of your background story and how you got involved in this space in the first place.

Brian Nyquist: Absolutely. Not especially but I am. My background is in human biology and public health focusing sort of on health policy. I started out while I was working through grad school and, bio safety, occupational health, institutional bio safety, research compliance, things of that effect. So I basically dedicated my career to helping other people whether that’s keeping them safe when they’re engaging in research with bio hazards bio hazardous material, recombination DNA, things of that effect all the way up to research involving humans. Also, just helping people understand the complexities of our healthcare system, how to navigate the insurance landscape, and really get the coverage and the care that they need.

Dylan McCabe: You have a scientific background and I didn’t even know that until today, which is awesome. So taking that scientific background. Did you stay while you were working on a master’s?

Brian Nyquist: Yes. My undergrad is in human biology, focus on genetics, and then my graduate degree is a master’s in public health with a focus on health policy and management.

Dylan McCabe: That is so interesting. So what kind of led you to go to take that knowledge and that skill set? I mean, what led you to where you are today with the National Infusion Center Association.

Brian Nyquist: So I guess the story of how I got from graduate school to here is kind of just a series of fortunate opportunities. As soon as I graduated I came back to Austin and at that point, we had just started a legislative session in Texas and the newly appointed chair of the public health committee had no public health background and so she reached out to the Dean of my Alma mater looking for an expert in public health that was in or around the Austin area and for whatever reason, my name came up and so I got a call. The Dean of my school asked if I’d be interested in serving the state as a sort of policy analyst for the house committee on public health and the state legislature.

Brian Nyquist: It’s not every day that you get the opportunity to sort of be involved in the public health legislation within your particular state. So I took that opportunity, worked a legislative session. Then at the end of the session, I was connected with the founders of NRCA, who were looking for somebody to come in and provide strategic direction day-to-day oversight, really build the organization sort of up from the ground. The organization at that point was operated remotely virtually on a part-time basis by the founders. So it was just kind of right place, right time. Two positions in a row and the opportunity NRCA was a great opportunity for me to continue applying my passion for helping others and get me into a position where I can really dive deep into the healthcare industry and more particularly within a growing niche. I was incredibly excited about it. That legislative session we had, the biosimilar substitution bill come through committee. So I had already been really deep in the whole concept of biologics and bio-similarity, biological products, interchangeability things of that effect. Some of the science behind the autoimmune disease and so it was just incredibly intriguing and interesting on a variety of levels that was really attracted me to that opportunity. But most attractive was a combination of the ability to apply all of the skills experience and strengths that I’ve built to this point in a capacity where I can help people get access to this growing sort of area of medicine.

Dylan McCabe: So for I’ve got so many questions that are coming to my head about all this. So for people listening to our podcast, I mean, we’ve got CEOs, doctors, nurses, all kinds of people listening. Some people may not even know about the national infusion center association. So can you explain what that is for people wondering about that?

Brian Nyquist: So the National Infusion Center Association is 501C3, which basically just means we’re exempt from federal taxation. We’re organized as a public charity, we’re a patient advocacy organization, a nonprofit patient advocacy organization. We were formed with the mission to improve patient access to providers administered intravenous and injectable medications. So we focus on the provider, administered parenteral products, essentially covered under the medical benefit. As I came on board looking at the various dynamics of the industry, some of the challenges and hurdles and moving me this particular segment of the healthcare system forward. It became pretty apparent that the best way to preserve and expand patient access to these particular products in this care was by supporting this historically underrepresented delivery channel and more particularly this historically underrepresented segment of the infusion delivery channel, which is the non-hospital non-oncology office-based care setting which two primary sites of care models that fit under this unquote infusion center component to our name. The specialty physician office-based infusion facility, as well as the independent standalone ambulatory infusion center model as well. So we achieve our mission by supporting this particular segment of the infusion delivery channel, mainly in three ways through advocacy, education, and resource development. From an advocacy perspective, we work to identify address, and overcome access challenges, barriers to patient access to care, as well as threats to this medication delivery channel. So that infusion provider, their staff don’t have to, they can instead focus on providing care for their patients. From a provider focused education perspective. We work to connect infusion providers and their staff with the educational materials they need to most effectively educate, communicate with, and ultimately care for their patients. From a patient-focused education perspective. We work to equip patients with educational content. They need to empower them to take a more active and collaborative role in shared decision making, as it influences the management of their condition, as well as to be a more active advocate for their overall access to healthcare and then finally, from a resource development perspective, we work to connect infusion providers, staff with the tools and resources they need to ultimately improve their capacity to care for patients.

Dylan McCabe: That’s so interesting. So it sounds like a big part of the NICA it’s pushing for patient care. It’s taking care of issues that involve patients and also a lot of education. So in the midst of all that, you’re taking trips to Washington, DC you’re here in Florida right now with us. I know you travel a lot, you’re doing a lot of things to benefit everybody involved. So what is your main area? What would you say is your main area of expertise in all this?

Brian Nyquist: Within the area of in-office infusion?

Dylan McCabe: Yes.

Brian Nyquist: I would say the health policy component, based on my background, previous experience in public policy, specifically focusing on health policy. I’m able to really dive into a lot of the proposed changes, whether those are legislative or through the rule making process. So CMS, the center for Medicare Medicaid services through the center for Medicare and Medicaid innovation also referred to as CMMI. Produce demonstration projects, things of that effect to test various aspects of reform. I have the background and sort of expertise to really dive into the legislation and some of these rules essentially to pick apart, what are they trying to achieve? What aspects of existing sort of statute are they looking to modify, and what impact is that going to have on patients’ access to care? And a big component of that is how is this reform going to impact the in-office infusion delivery model and the dynamics within that care setting?

Dylan McCabe: Are you talking specifically about like a bill that could be passed and how that would affect patients or something like that?

Brian Nyquist: It could be a bill which is a legislative change that goes through Congress at the federal level or at the state level and then there’s also reform that could happen through the rulemaking process, which is independent of the legislative process. So CMS has the ability through this new program, which was formed under the affordable care act CMMI, which I referenced previously. They can essentially implement reform in the form of demonstration projects, basically experiments, and that those projects don’t require congressional approval. So they’ve been granted the authority to test various reform measures, independent of Congress approval.

Dylan McCabe: It was so interesting. What’s out of that, what’s one big thing you would want our listeners to take away from, from your main area of expertise?

Brian Nyquist: I guess they don’t have to do it. Infusion providers don’t have to bring staff on with a public policy background to try and stay up to date on all of the legislative reform rule makings that potentially impacts and reshapes the delivery channel for the regular, the regulatory landscape or the reimbursement landscape. NICA is positioned to do that basically. That’s a heavy focus of ours. So historically we’ve been heavily focused on advocacy and that policy and rule making component is a big piece of that advocacy component.

Dylan McCabe: That’s why I love that because he’s fighting on behalf of all of us, even though many providers may not even know you exist, right. If they haven’t heard of the United Way, and yet they’re doing these things in Washington that are, that are really big, that affects us all. So I’m going to stop with all my questions and comments, because I’m just getting all wound up. Reece, what would you like to add to that?

Reece Norris: Well, Brian, how do we learn more about the NICA? You’ve obviously got a website, what’s the website domain. What are some of the resources there? I mean, I know I’m just kind of prompting you so our listeners can learn more.

Brian Nyquist: Our website can be found in On that website, you can find some of the advocacy efforts that we’ve been engaged in historically some of the advocacy efforts that we’re currently engaging in. As well as the educational materials that we’ve developed and some of the resources that I’ve mentioned in sort of that intro and background behind NICA. So some of the educational materials that we have on our website right now include infusion 101 foundational level. What is an infusion? What types of conditions are treated via infusion? What types of medications are delivered via infusion? We talk about the different care settings in which you can get this care. We’ve got a glossary of insurance terms and healthcare-related terms to help patients kind of understand some of the jargon that insurance companies are using and their benefit plan design.

Brian Nyquist: We’ve got a module that helps walk individuals through how to acquire a health plan through the marketplace, As well as kind of a breakdown between Medicare, Medicaid, things of that effect. We’re working on a slide deck that kind of provides a breakdown of the entire insurance landscape from commercial to public. Some of the resources that we have available. We have an infusion center locator resource, which is the most comprehensive database of outpatient infusion across the country and that is the most comprehensive database that is publicly available in the world. To our knowledge, we have about 3,200 infusion facilities covering all 50 States as well as the District of Columbia and Puerto Rico. The goal of that resource is to really help connect patients with the most conveniently accessible site of care within their community, in which to get infused.

Dylan McCabe: I just love how it keeps going back to the patient. We’re really seeking the common good for the patients.

Brian Nyquist: That’s what we do. We’re focused on the patient. Patients have to get access to this care, right? Majority of these patients have an autoimmune disease and if they have been prescribed a biologic, conventional therapies have failed to manage the progression of their disease. So if we can’t get them stable, if we can’t put their disease state into remission as quickly as possible and keep them in stable, as long as possible, the annual per capita economic burden of that autoimmune disease skyrockets can more than double. So it’s absolutely imperative that we overcome all of these obstacles that patients are facing to getting those medications and a lot of those hurdles are threats to the sustainability of this in-office infusion model. As we’re seeing increasing attention at controlling, the rising cost of care and medical benefit drug spend is seen as the leading driver. We’re seeing a lot of efforts, both in Congress, as well as rulemaking processes that are trying to control that medical benefit drug, spend component, and the primary target for intervention is the margin on infusion providers, drug payments. So infusion providers have been forced to operate in a volatile reimbursement environment with an increasingly pressurized atmosphere to operate on narrower and narrower margins. There’s a threshold beyond which providing care is no longer financially sustainable. It’s not viable. So if you’re losing money to treat a patient population in the office, you’re not going to treat that patient population in that care setting and the alternative for that patient is a hospital care setting, which is significantly more expensive per patient per treatment. So everything that we focus on doing is getting patients into the office, keeping them in the office, and getting them on the prescribed therapy, which in our cases is typically biologics and other injectable specialty medications like IVIG and, and so forth. So we’re most certainly patient focus with patient-centric. But as I mentioned earlier, the most effective way for us to ensure patients have access to these products is by making sure that they have a more affordable, accessible, and compassionate alternative to hospital care settings. In this case, that’s the office, whether that’s a physician office setting, or these independent standalone infusion center models.

Reece Norris: So if you’re listening right now, you have a provider based an infusion center, you’re billing under the medical benefit or Medicare part B as in boy, and we highly encourage you to register on the infusion center directory if you haven’t already. I think that’s one of the key ways where patients find sites of care and full disclosure. I am on the board of the NICA and I was one of the founders. So very passionate about making sure providers are registering through locator because not only does that get patients a place and a forum it establishes you. We can get in touch with you as well at the national infusion center association and get involved. Join the National Infusion Center Association, if you’re a standalone infusion center or a provider whether that’s a physician or a nurse practitioner that has an infusion center, typically you have a lot of rheumatologists, a lot of neurologist, gastroenterologists, and immunologists that are involved in National Infusion Center Association. So we absolutely encourage you to get in touch with Brian and his team to learn how you can support his efforts.

Brian Nyquist: Just want to take that one step further within that infusion center locator. If your facility is already in the locator, you can claim that facility, and then once we validated that you’re affiliated with that facility and that in the position to administer the profile for that facility in the locator, you’ve got access to build out the profile for that facility within the locator. So you can populate hours of operation, amenities, things that affect medications, delivered specialties treated number of chairs, things of that effect provider members of NICA also have the ability to upload high-resolution images and their profile as well. So they can take pictures of the facility and basically post them within their profile. It’s a free marketing tool to help increase awareness of that facility. So just a quick kind of overview of how the locator was built to work. When a user goes to the locator at the first instance, there’ll be asked a few questions, trying to capture some demographics of each use case. But then it auto-populates a list of infusion facilities within a default of a 30-mile radius from where the individual is accessing the locator. We’ve also built in some sophisticated search ability so that they can search for facilities by geography, by zip code, by state, by city, within a particular radius up to, I think it’s a hundred, maybe 150-mile radius, and they can search by a particular product by specialty, by certain amenities, things of that effect. It’s important to have your profile built out and populated because users are searching for a facility within their area or a different area based on some of the information that’s captured in that profile.

Reece Norris: In addition to the locator, one of my favorite resources is the forum as well. So tell us about the infusion confusion forum.

Brian Nyquist: Fusion confusion form. So fusion confusion forums are our online support network community for infusion providers and their staff to come together. Talk about some of the challenges that they’re facing, whether they’re operational clinical reimbursement related, regulatory, in nature. They can sort of collaboratively develop some accommodation strategies to address and ideally overcome some of those challenges. It also provides a sort of soundboard for us to stay up to date and in tune with what are some of the issues that providers are facing across the country. We’re also working to build a patient side of that community so that we build an infusion patient community essentially. There’s been a lot of demand for that and it’s free to use. Anybody can go in and read. What’s been posted, you do have to create a free user account through our website to be able to post within the forum. As well as to claim a profile in the locator. We have all of those things behind a login firewall.

Dylan McCabe: I love it. I love forums. Go ahead.

Reece Norris: No forums. Yes. In fact, I just answered a question on the forum recently about infusion pumps. So it’s definitely to Brian’s point, it covers the whole gamut of questions that you could encounter as an infusion center provider. I recently got a newsletter and want you to tell our audience here about the upcoming conference, that this will be your first conference that the national infusion center association is putting on.

Brian Nyquist: Yes, it’s our inaugural show, basically. We’re, we’re incredibly excited. It’s sort of been in discussions for about three years now. We finally kind of have the staff capacity and bandwidth to really throw a show. This show is going to be in late June 2019 in Austin, Texas, and it’s going to be focused on in-office infusion, the operational and clinical challenges facing in-office infusion, both now and then with challenges on the horizon, basically. The theme is really going to be on optimization and expansion. So what do we need to do to optimize the existing infusion delivery channel, to maximize infusion capacity and ability to treat patients within the current infrastructure of the delivery channels? And then how can we expand access to care by establishing additional access points to the delivery channel? We’re building a resource right now that is basically going to be a turnkey roadmap for how to do that. If you have an existing infusion, a line of business incorporate in your practice, how do I optimize it? What are some of the things I need to be looking at from both the performance measurement capacity, as well as the quality of care? So patient outcomes, side perspective and then if you were looking to expand your infusion operations across state lines, and you’re not sure what the regulatory landscape looks like, we’re doing a comprehensive analysis right now, and breakdown of the regulatory landscape at both the federal level and the state level by state. Basically it’s a roadmap for how to start an infusion center infusion facility. Whether that’s associated with a physician practice or an independence type model. So the big focus of the show is going to be on what do we need to do as a delivery channel to optimize maximize efficiency and work to expand. One of the big challenges that we’re currently facing. The delivery channel doesn’t have the capacity to meet patient demand for existing products on the market across all care settings, hospitals, offices, and homes. So if we’re going to you support and justify continued investment in bio pharmaceutical research and development, there has to be capable in the delivery channel. As I mentioned earlier, there’s a lot of focus on controlling the rising cost of care. So commercial payers already understand the value proposition of the office versus the hospital. So we have to build capacity in non-hospital care settings to not only meet existing demand for the products that are currently on the market but to support demand for when we get all these biologics and all these other IB, injectable especially medications it’s coming out of the pipeline, essentially. Especially if we get an Alzheimer’s product that comes out, that’s going to be administered in the office. I mean, that’s a huge, enormous patient population that’s going to be coming in. Right. A huge segment of market share and we got to make sure that infusion providers, particularly it’s office-based infusion providers, are able to take that market share essentially and be able to provide a care setting for those patients.

Dylan McCabe: So is that one of the biggest challenges on the horizon is trying to make waves that we’ve got more doctors, offices, more provider offices doing infusions?

Brian Nyquist: Yes. I mean, the biggest challenge right now its sustainability. There is a lot of threats, market dynamics, and forces that are working against the sustainability of the in-office infusion delivery model. As I mentioned, the fall towel reimbursement landscape, increasingly pressurized atmosphere to operate on narrower and narrower margins. There are a lot of challenges that we’re trying to overcome right now just to preserve the existing delivery channel. But we also have to make sure we don’t lose focus on the future. We have to work to support a landscape in which the office-based infusion delivery channel is free to expand, not just free to expand, but we have a reimbursement landscape and a regulatory landscape that really supports and drives the expansion of the office-based delivery channel.

Reece Norris: Without that, where do the patients go?

Brian Nyquist: Exactly what they’re going to go into the hospital.

Dylan McCabe: Yes, that’s just the perfect layup to me to give a plug where WeInfuse because we talk, even at this conference, we’re at FSR and we’ve had so many doctors come up to us saying, the infusion practice that we have is intense and risky because if we mess up on one buy and bill drug, or one claim, we lose track of one vial. We make a mistake in one patient when it comes to the whole benefits investigation process, it could be catastrophic and so that’s the whole goal behind WeInfuse the software. For those of you listening, if you haven’t seen a demo yet, please check out and just schedule a demo, and you can see how we have everything tied together. The benefits investigation process, a chair based scheduling feature, and infusion nurses note that’s connected to the inventory. We even have inventory management, ordering, and reports and reconciliation, so that this incredibly unique practice slash business model can be managed. We can reduce the risk, we can reduce human error as much as possible so that those of us in the clinical setting can focus on the clinical part and not worry about these details that become snags to these provider offices. So definitely check out, We also have a great blog post by Reece and Brian and others that educate and equip all of us that are involved in the infusion space. All right. So there’s my shameless plug for WeInfuse. Now back to what we were talking about with all these challenges and the things that are happening that affect us all, tell our listeners what you’re most excited about?

Brian Nyquist: Before I answer that question and come back to that question, I wanted to touch on something that you’d sort of brought up. I think it’s so fantastic what you guys are doing to really support the optimization and the expansion component.

Dylan McCabe: Now take your time with this. Okay. I feel like you’re about to say a lot of really important stuff.

Brian Nyquist: So one thing that I’ve noticed, going through medical school. Whether that’s a medical school to become a physician or nursing school to be a nurse or an advanced practice nurse, a physician’s assistant things of that effect, those curricula don’t typically include a business management component, certainly not a focus on practice management. So if you look at industries across the world, there are very few where you have multimillion-dollar lines of business being managed by high school graduates, right. Or people without a background in business management or performance management or program management. This is one of the challenges that is facing the sustainability of this model. Not saying you got to fire your practice manager, director of infusion services right now, and go out and find an MBA. What I’m saying is don’t be afraid to acknowledge that you’re not strong in every area. We all have our strengths. We all have our weaknesses. What’s important is to understand the areas in which your practice is weak and find solutions and strategies to address those weaknesses. An example of which, if you go taking a step back, managing buy, and bill and fusion inventory, there is extraordinary opportunity costs in financial risk and investing in maintaining a buy and bill inventory. Hundreds of thousands of dollars in a fridge. You are opening yourself up to enormous risk, catastrophic loss of product, things of that effect. If you don’t manage just your inventory component, you could jeopardize the sustainability of that practice. So one of the things that NICA is doing is we’re exploring strategic partnerships with organizations that produce goods or services that can help infusion providers do what they do better. I think what you guys are doing it, WeInfuse is phenomenal. It’s needed. Absolutely, and I am excited to have some of these dialogues at our annual meeting to really talk about what are some of the areas that we see practices are weakened from a management perspective. What can we do to really build up a robust sort of portfolio of skills, and strengths, things of that effect? How can we address those weaknesses by bringing in external solutions that are strong in those areas of weakness to really set these practices up for success? Not only in the now, not only in the intermediate-term but over the long term as well.

Dylan McCabe: That’s so great. That kind of goes back to something we talked about when you were on the show recently. So what’s one of the keys to a successful infusion practice and right away, you said the team you have, and that’s interesting because to your point, I’ve never heard it put that way, but that’s true. We’ve got a multi-million-dollar business model that oftentimes is not being run by people that’s really their specific training is how to run a business and the focus is lopsided on the clinical side. As you said, I mean, we have practices that are ordering hundreds of thousands of dollars of drugs a week. That’s a great way to put it. Well, this has been so helpful. There’s so much more, we could talk about a bit, make sure we don’t this podcast doesn’t go on for an hour. What’s one last piece of advice you would want to impart to our listeners.

Brian Nyquist: Advocacy is going to be the secret sauce for overcoming these challenges in the now and in the future. Together we are stronger than we are individuals. It’s not difficult to advocate, NIICA does it every day, but without the provider and the patient perspective to establish the human connection to our advocacy efforts, it’s seen as a nonissue. So it’s absolutely critical that we get providers and patients to use their voice, to advocate and leverage that voice, filter that voice through a NICA. So we can amplify that into a cohesive and collaborative advocacy voice, so we can develop the collaborative momentum behind these access challenges and threats that we’re working to overcome and we can do what we’re seeing on the oncology space. We need the cohesion, we need the mobilization, we need the sustained engagement, and we need the collaboration that we’re seeing in the oncology space. If we’re going to overcome challenges and we have to come together across all of these non-oncology specialties, we got to have one voice.

Dylan McCabe: That’s great. I love that. I mean, it really is. It’s amazing how you can come together and really push for, for it. So can people get involved in those provider offices listening or different people listening? Do you want to get involved? What can they do?

Brian Nyquist: Go to our website, sign up for our newsletter. We’ll send out a sort of call to action through our newsletter. As well as our social media channels, follow us on our social media channels. If there’s a call to action for an advocacy effort, we’ll send it out through those channels. Depending on the nature of the advocacy effort, we may think it may be necessary to have a grassroots advocacy component involving letters or calls or social media. We’ll have directions and things of that effect of how individuals, stakeholders, essentially across all of these stakeholder groups can really get involved in these advocacy efforts. Our advocacy platform is incredibly simple. We call it toilet seat advocacy. I mean, you click to click a few buttons. You enter in your address and you can send letters to your elected officials.

Dylan McCabe: Never heard that before toilet seat advocacy.

Brian Nyquist: 2016 a Medicare part B payment demonstration that was proposed to cut. Medicare part B reimbursement from ASP plus 6%, 4.3% under sequestration to ASP plus.

Reece Norris: One, but it was it to be less than one with sequestration.

Brian Nyquist: After sequestration, it was going to be ASP plus like 0.89% plus $16. 80 cents, which would not be sustainable. So in response to that, we leveraged our grassroots advocacy platform. There’s toilet seat advocacy, essentially to send 40,000 letters to DC the Hill in three weeks and 15,000 letters in the first four hours on the day of peak engagement before the Sergeant of arms for the Senate called our platform vendor and shut down that line of communication because we essentially broke the email infrastructure in the Capitol.

Dylan McCabe: That is incredible. Just incredible.

Brian Nyquist: That’s the power of collaborative advocacy.

Dylan McCabe: Yes. It’s because I think so many people listening to think, that’s great. What Brian Nyquist is doing, but what can I do? Clearly you can do a lot when everybody comes together.

Brian Nyquist: Its synergy is an incredibly powerful concept, particularly in advocacy. We can go in and say that providers are having an issue, say that patients are not getting access to care because of some policy issues or some rule making change. But without that human connection, without the patient and the provider perspective, it’s seen as a nonissue. I did a public policy session at McKesson’s on Mark rheumatology summit a few weeks ago in San Antonio and the theme of that message was the squeaky wheel gets the grease. Every issue in DC, there are two sides too. You got two sides working on their perspective of the issue, their outcome. So each issue from a legislator’s perspective has two squeaking wheels. So every wheel is squeaking. So how do you get the grease? When every wheel is squeaking, you have to be the loudest wheel and together we can be the loudest wheel always, but we have to come together and NICA was formed to be the cohesive advocacy voice across non oncology specialties for patient’s access to in-office infusion.

Brian Nyquist: We’re the channel we need to funnel those perspectives, the perspectives of stakeholders through the NICA channel. We can have the loudest advocacy, voice handed down model, hundreds of thousands of patients, thousands of providers. We can all come together and we can really drive responsible and sustainable reform because we have to, if we don’t do it, somebody’s going to do it for us and the outcome is going to be sub optimal. If it’s CMS or if it’s legislators, any non-stakeholder that doesn’t understand that unique characteristic of the infusion delivery channel, the unique dynamics of managing these complex chronic conditions with these particular products, whatever solution they come up with is not going to be the solution that we want. So until we come together as stakeholders and funnel all of our individual voices through a single cohesive, collaborative advocacy voice is going to come in and tell us how these providers need to operate, how the delivery of care needs to look, and ultimately how reimbursement looks, how the regulatory landscape looks. So we got to come together because the sustainability and the long-term viability of this model depend on it.

Dylan McCabe: That’s so good. If you’re a provider office by yourself, you’re just going to be a whisper in the wind. But if you come together with the NICA you have a megaphone, you have a platform for everyone to use. It’s so good. Obviously people can donate to the NICA as well. To become part of that movement and one more time, the website is Well, that’s excellent. Well, Brian, thank you so much for being on our podcast, man. We know you’re busy, but we really appreciate you sharing your story and what the NICA is doing with all of our listeners.

Brian Nyquist: Appreciate the opportunity.

Dylan McCabe: Reece, thanks for joining the podcast as well as the cohost.

Reece Norris: Always a pleasure.

Dylan McCabe: All right, guys. Well, for those of you listening, thank you for joining us in the journey of infusion. This is the WeInfuse Podcast where we take the confusion out infusion and we will catch you in the next episode.

Guest Speaker: Brian Nyquist, MPH is the Executive Director at the Infusion Nurses Society (INS), and CEO at the National Infusion Center Association (NICA). He works to ensure the safety and efficiency of the community-based infusion center, and emphasizes the value of these cost-effective alternatives to hospital care. Prior to joining NICA, Brian was a Policy Analyst for the Texas House Committee on Public Health.