Reducing readmissions with pharmacist-integrated care in Medicare value-based programs.

Area of Science:

• Health Services Research
• Clinical Pharmacy
• Population Health Management

Background:

• Pharmacy transitions of care (ToC) programs are known to reduce 30-day hospital readmissions.
• Limited data exists on the long-term impact of pharmacist-integrated ToC services beyond 30 days.
• Medicare value-based programs (MV-BPs) incentivize readmission reduction.

Purpose of the Study:

• To evaluate the impact of pharmacist-integrated ToC and population health services on 30-, 60-, and 90-day all-cause readmissions in a Medicare value-based program (MV-BP) population.
• To compare the mean time to first readmission with and without pharmacist care.

Main Methods:

• Retrospective observational chart review of hospital discharge encounters (DEs).
• Patients (≥18 years) in an MV-BP were assigned to a control group or one of three intervention arms based on pharmacy ToC services received.
• Services were provided by inpatient ToC pharmacists or dedicated population health pharmacists (PHPs).

Main Results:

• Among 1,039 patients with 90-day follow-up, the control group had a 34.74% readmission rate.
• Intervention arms 2 and 3 showed significantly lower 90-day readmission rates (9.57% and 17.07%, respectively) compared to control.
• Intervention arm 1 did not show a significant reduction in 90-day readmissions (29.85%).

Conclusions:

• A combination of ToC and PHP services effectively reduced 30-, 60-, and 90-day readmission rates in the MV-BP population.
• These findings highlight the benefit of integrated pharmacy services in minimizing long-term readmissions.
• Expansion of pharmacy-based ToC services is recommended for this Medicare population.