Resource:

WalgreensWellTransitions: Over 50% Reduction of Hospital Readmissions in two years at Texas based Health System

Case Study

Challenge: Care Continuum  Financial Sustainability  

Content provided by AHA Endorsement partner: Walgreens

Learn how Two Valley Baptist Health System hospitals reduced readmission rates by 51.1% from 2011 to 2013 by changing their approach to readmission management and by implementing Walgreens WellTransitions program.1


The Challenge
Preventable hospital readmissions cost the U.S. healthcare system $25 billion annually.2 An estimated 20 percent of hospitalized Medicare patients are readmitted to the hospital within 30 days of discharge.3 This costs Medicare

$15 billion, with 80% of the cost due to preventable readmissions. Taking measures to reduce readmissions is now a number one priority.4

Valley Baptist Health System (VBHS), a medical center in Texas with a 586 licensed- bed health system in Harlingen and a 243 licensed bed health system in Brownsville, sought to reduce readmissions by redesigning their discharge process and by improving the follow-up with patients and caregivers.

The Solution
VBHS developed several complementary programs to reduce readmission rates. These efforts began with a strong, physician-led palliative care and hospice initiative to educate families and caregivers about the management of their patient’s health.

The next step was to ensure that patients received education regarding their health condition during their stay and that they had an appropriate follow-up care after their discharge from the hospital. As part of their new transitional care management initiative, VBHS has partnered with Walgreens to implement the WellTransitions program focused on medication education and adherence for all high-risk patients. This was not only to support medication compliance but also to better engage the patients and caregivers in the follow-up care.

Upon enrollment in the WellTransitions program, a medication history was generated for each patient and provided to the hospital team to assist with the patient’s medication review. During their hospital stay, eligible patients were offered the convenience of filing and delivering the prescribed discharge Medication at bedside prior to leaving the facility, ensuring immediate start of the therapy care plan. A pharmacist performed multiple follow-up calls within 30 days after the patient’s discharge.

The results
With their multi-pronged approach to readmission management, and by implementing Walgreens WellTransitions program, two VBHS hospitals reduced their relative rate of readmissions by 51.1% - from 28% in 2011 to 13.7% as of November 2013.1

Reduction in readmissions rates significantly lowered Medicare readmission penalties and from October 2012 to September 2013, Harlingen hospital went from a 0.82% penalty to a 0.20% penalty. Brownsville hospital fell from 0.63% to 0.18%. This has real value not only for the health of their patients, but also for the hospital’s financial performance: between the two hospitals they saved approximately $750,000 over eight months.1

Additional data has shown that pharmacist follow-up calls contributed to 57% reduction in 30-day readmission rates relative to control group in 2013 at VBHS. Analysis of data by core health conditions illustrates how pharmacist follow-up contributed to a 54% (AMI), 50% (COPD), 68% (HF), and 28% (PN) reduction in 30-day readmission rates compared to control group for core measure disease states in 2013.

Walgreens WellTransitions takes a comprehensive approach to reducing readmission rates by working with patients from the time they are admitted to the hospital through their discharge and return home. The program supports patient recovery through several hospital-to-home transition steps designed to improve wellness and reduce readmission rates while increasing patient satisfaction and lowering overall care costs.

This innovative, coordinated care program aimed at improving medication adherence has demonstrated reductions in hospital readmission rates by helping patients better understand prescription therapies during and after their discharge.


References:

1. Walgreen Co. Data on file.

2. PriceWaterhouse Coopers’ Health Research Institute. (2008). The Price of Excess: Identifying Waste in Healthcare, 2008. Retrieved from http://www.pwc.com/us/en/healthcare/publications/the-price-of-excess.jhtml. Accessed April 29, 2014.

3. Gerhardt G, Yemane A, Hickman P, Oelschlaeger A, et al. Data shows reduction in Medicare hospital readmission rates during 2012. Medicare & Medicaid Research Review 2013. 2013;3(2).

4. Medicare Payment Advisory Commission (MedCAP). Report to the Congress: creating greater efficiency in Medicare. Available at http://www.medpac.gov/documents/Jun07_ EntireReport.pdf. Accessed September 16, 2012.

5. Jencks, S.F.,Williams, M.V., Coleman, E.A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New Engl J Med. 360(14), 1418–1428