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

PURPOSE

Pharmacy transitions of care (ToC) programs have been shown to decrease 30-day hospital readmissions and improve patient outcomes, but there is limited published data on the impact of pharmacist-integrated ToC services beyond 30 days. The objective of this study was 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 and to compare mean times to first readmission with and without pharmacist care.

METHODS

A retrospective observational chart review was conducted to identify eligible hospital discharge encounters (DEs). Patients 18 years of age or older enrolled in an MV-BP were assigned to 4 study groups (a control group or one of 3 intervention arms) based on the pharmacy ToC services they received from either an inpatient ToC pharmacist or a dedicated population health pharmacist (PHP).

RESULTS

Among 1,065 eligible DEs, 90-day follow-up was completed in 1,039 cases. The control group (n = 213) had a 90-day readmission rate of 34.74%. Intervention arm 1 (n = 201) had no significant reduction in 90-day readmissions, with a rate of 29.85% (odds ratio [OR], 0.94; 95% CI, 0.61-1.47; P = 0.80), while intervention arms 2 (n = 209), and 3 (n = 416) had significantly lower rates of readmission: 9.57% (OR, 0.26; 95% CI, 0.15-0.46; P < 0.01), and 17.07% (OR, 0.41; 95% CI, 0.27-0.61; P < 0.01), respectively.

CONCLUSION

A combination of ToC and PHP services reduced 30-, 60-, and 90-day readmission rates in an MV-BP population. These results support the expansion of pharmacy-based ToC to minimize readmissions within 90 days for this Medicare population.