Editorial: Transitional Care Clinics to Reduce 30-day Readmissions in Heart Failure Patients

Heart failure (HF) is one of the most prevalent chronic diseases in the United States (U.S.), with an estimated prevalence of five million patients in the U.S. and an annual healthcare cost of greater than 30 billion dollars. Readmission rates for HF patients are astronomically high, with up to 25% of hospitalized patients with HF requiring readmission within 30 days of discharge. The Hospital Readmissions Reduction Program (HRRP) of the Patient Protection and Affordable Care Act aims to address these concerns by financially penalizing institutions with unacceptably high risk-adjusted 30-day readmission rates for HF patients. The introduction of the HRRP contributed to increased efforts of healthcare systems to reduce their 30-day readmission rates, often by the utilization of "transitional care clinics." Although the motivation for the creation of these programs is understandable, there exists a paucity of robust clinical trials supporting the efficacy of these programs to reduce 30-day readmission rates for HF patients. There is even less evidence to support the use of these programs in the unique healthcare environment of the U.S. Large, multicenter randomized controlled trials should be conducted to evaluate these interventions before more resources are dispersed toward their implementation. Alternatively, resources could be used to evaluate other interventions that may be more efficacious at reducing 30-day readmissions, such as implantable hemodynamic monitoring devices.