IV Hydration Clinics: A Hot Concept Weighed Down by Risks

By Peter Reilly

What’s not to like about those IV hydration clinics that are springing up just about everywhere?

Their popularity with consumers as a self-care cure for hangovers and more has driven the North American market to $1.6 billion, and an 8.7% annual growth rate through 2030 is predicted. They’re also big moneymakers. Owners can expect profit margins of 30% to 80%, thanks to demand combined with comparatively low overhead costs.

Even so, it’s a business rife with risks that should concern current and potential operators, not to mention consumers themselves. Understanding their scope and managing them effectively needs to be priority for the sake of patient safety and, ultimately, business sustainability.

Red flags raised by operational practices 

One of the first IV “pop-ups” was a hydration clinic on wheels, a 45-foot-long bus branded as “Hangover Heaven” that was popular on the Las Vegas strip beginning in 2010. It was the brainchild of Dr. Jason Burke, a board-certified anesthesiologist, an easily accessed way to recover from excess libations.

The concept has since exploded. IV hydration therapy is provided in med spas, in temporary, non-medical settings like a tent at a festival, as a traveling amenity to hotel guests or an in-home service.

The menu of IV fluid “cocktails” has also expanded to various mixes of saline, vitamins, amino acids, and even prescription drugs. It’s often resulted in less-than-rigorous vetting of suppliers and their products to avoid contamination or faulty packaging. Clinics’ licenses have been suspended for selling unapproved or mislabeled drugs in their hydration mixes—one operator admitted to buying at deep discount through a Facebook group.

Just as concerning is the extent to which clinical standards are met in this non-medical environment. Therapy must be administered by a qualified medical professional. But that doesn’t guarantee proper training for managing the downside risks like toxicity.

Then there’s the oversight issue

Many of the risks could be lessened with better and more consistent oversight. Currently, IV hydration clinics are subject to a patchwork of federal, state, and local regulations that result in spotty enforcement. The compliance risks should concern operators as well as patients, and impact liability insurance coverage.

There are no standard operating procedures for mobile hydration operations at the federal level. States have varying rules on licensing requirements for who is allowed to provide services, training required and scope of practice.

Typically, regulations specify that services must be administered by trained and licensed medical professionals like nurses or physicians; some states allow licensed phlebotomists or paramedics to administer IVs.

California and New York are considered regulatory exemplars. Their rules are strict and emphasize physician ownership and comprehensive requirements for IV therapy administration. States with more lenient Corporate Practice of Medicine (CPOM) laws also may have more relaxed operational requirements: Anyone can own an IV therapy clinic in Alaska or Delaware; Ohio allows non-physician ownership but requires a licensed physician as medical director.

Best risk management practices

Insurance coverage for the various risks can be secured. But operators should be aware that the policies don’t come cheap. And the coverage may not be the most robust. That makes solid risk mitigation strategies essential, especially given a litigation environment where nuclear verdicts of $10 million or more are common.

A good starting point is with processes, specifically those for acquiring all the materials that are required to safely provide IV hydration. This means that dependable supply channels are set up and working. An adequate inventory of the materials necessary to provide the service is on hand and a process is in place to guard against shortages. Other processes need to be put in place to establish what’s in the fluids and what, specifically, is being utilized for clients.

Secondly, clinical procedures must be spelled out in detail, supported by training and appropriate medical supervision. More than simply “how” to put a needle in a patient’s arm, staff must be trained to recognize and respond to potentially negative turns—say, allergic reactions or excessive bleeding.

Finally, accountability—well-documented policies, procedures and controls, especially relative to employees—is critical. An IV hydration clinic may have done everything by the book, but could still have a negative outcome. The best defense will hinge the ability to point to solid documentation and controls. That’s how to position the business for the long haul.

Peter Reilly is the practice leader and Chief Sales Officer of global insurance brokerage Hub International’s North American healthcare practice. In this role, he directs and coordinates HUB’s healthcare planning, growth, and strategic initiatives. He also works with other leaders and experts within HUB to develop and introduce proprietary products that will help healthcare organizations and providers across the care delivery spectrum.