An Insurer's Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs

Health Aff (Millwood). 2016 Jul 1;35(7):1222-9. doi: 10.1377/hlthaff.2015.0648.

Abstract

Adverse drug events and the challenges of clarifying and adhering to complex medication regimens are central drivers of hospital readmissions. Medication reconciliation programs can reduce the incidence of adverse drug events after discharge, but evidence regarding the impact of medication reconciliation on readmission rates and health care costs is less clear. We studied an insurer-initiated care transition program based on medication reconciliation delivered by pharmacists via home visits and telephone and explored its effects on high-risk patients. We examined whether voluntary program participation was associated with improved medication use, reduced readmissions, and savings net of program costs. Program participants had a 50 percent reduced relative risk of readmission within thirty days of discharge and an absolute risk reduction of 11.1 percent. The program saved $2 for every $1 spent. These results represent real-world evidence that insurer-initiated, pharmacist-led care transition programs, focused on but not limited to medication reconciliation, have the potential to both improve clinical outcomes and reduce total costs of care.

Keywords: Health Spending; Medicare; Organization and Delivery of Care; Quality Of Care.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Continuity of Patient Care / economics
  • Cost Savings*
  • Delivery of Health Care / organization & administration*
  • Drug-Related Side Effects and Adverse Reactions / economics*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / therapy
  • Female
  • Humans
  • Insurance Carriers / economics*
  • Male
  • Medication Reconciliation / economics*
  • Medication Reconciliation / methods
  • Middle Aged
  • Patient Readmission / economics*
  • Patient Readmission / statistics & numerical data
  • Patient Transfer
  • Pharmacists
  • Professional Role
  • Propensity Score
  • United States