Implementation and Evaluation of Close to Me, a Novel Outpatient Clinic and Home-Based Infusion Therapy Program Through the Veterans Health Administration

PURPOSE Travel-related burdens are an ongoing issue for cancer and other specialty care patients. To address these issues, the Veterans Health Administration (VA) National Oncology Program sponsors the Close to Me (CTM) care model to facilitate novel care delivery strategies throughout the VA system. The VA Ann Arbor Healthcare System (VAAAHS) Hematology-Oncology Clinic implemented CTM, using local VA clinics and home-based therapies to reduce travel burdens for Veterans. METHODS Veterans eligible for CTM included those receiving infusion treatments through the VAAAHS who lived near a VA community-based outpatient clinic (CBOC) regardless of primary specialty, and Veterans with multiple myeloma receiving bortezomib subcutaneously. After enrollment, Veterans received their infusion therapies at a CBOC, administered by traveling VAAAHS infusion nurses. Veterans with multiple myeloma self-administered bortezomib at home under direct observation of an infusion nurse. RESULTS From October 2024 to June 2025, we enrolled 102 patients in the CTM program. Patients saved 21,840 total travel miles, for an estimated $8,954 of travel-related costs saved by patients receiving care at a local clinic or at home. A total of 261 treatment visits were completed, with an estimated $403,432 of potential drug cost-savings on the basis of VA versus Medicare Average Sales Pricing File data. There were no serious adverse events related to patients receiving therapy locally or at home, with overall 98.5% treatment adherence. Patient satisfaction was high, with most patients rating their experience as excellent and reporting that they would recommend this service to others. CONCLUSION The VAAAHS CTM program demonstrates the safety and feasibility of a local clinic and home-based infusion program through the VA, resulting in significant travel and cost-savings for patients. Our experience addresses issues related to the delivery of cancer care in both VA and non-VA settings.