A new study from the CVS Health Research Institute found that medication reconciliation programs, in which pharmacists review patients’ medication regimens and provide adherence counseling during the patient’s transition from hospital to home, reduced risk of hospital readmission by 50 percent and helped avoid unnecessary health care costs. The research, published today in the July issue of Health Affairs, is the first to evaluate the impact of an insurer-supported medication reconciliation program on clinical outcomes and health care spending.
“After leaving the hospital people are especially vulnerable and are often dealing with complex and changing care regimens, which can result in high rates of medication non-adherence and increased risk for costly and unnecessary readmissions,” said Troyen A. Brennan, M.D., executive vice president and Chief Medical Officer, CVS Health. “In fact, adverse drug events, often attributable to medication non-adherence, are associated with the majority of hospital readmissions. This research shows that programs that provide patients with additional support from a pharmacist can help improve health outcomes and save payers and patients money.”
The study analyzed hospital readmissions of more than 260 members of a national health plan who were hospitalized over a five-month period. Researchers compared readmission rates for patients enrolled in a medication reconciliation program upon hospital discharge to a control group of members who received no additional support following their initial hospital stay. Those enrolled in the program received an initial in-home or telephonic consultation based on their readmission risk and were also offered ongoing telephonic support for the first 30 days following discharge. During the initial consultations, pharmacists compared members’ pre- and post- hospitalization medication regimens; identified discrepancies, redundancies and safety concerns; and provided education and support regarding medication use and adherence. The researchers found that risk of hospital readmission at 30 days was reduced by 50 percent, reducing overall risk of hospital readmission from 22 percent to 11 percent for those in the medication reconciliation program. Additionally, the health plan saved $2 for every $1 spent on the program, resulting in a total savings of more than $1300 per member.
“The research found that the positive effects of the pharmacist consultation on reducing readmission rates and costs were similar whether the consultation was conducted via an in-home visit from a pharmacist or over the telephone when the intensity of the intervention was tailored to members’ risk,” added Dr. Brennan. “These results demonstrate that there is an opportunity for payers to consider adopting programs that provide pharmacist support and counseling by phone as a cost-efficient way to help improve medication adherence and health outcomes for their vulnerable populations.”
An estimated one in seven patients discharged from a hospital is readmitted within 30 days, and readmissions are associated with more than $41 billion in additional health care costs per year. In addition, evidence suggests that approximately 66 percent of hospital readmissions are the result of adverse health events related to medication non-adherence. Historically, health insurers have had little control over direct efforts to reduce hospital readmission rates for their members. When available, these kinds of programs are largely run by hospitals and outpatient providers and their impact has not been broadly evaluated.
The CVS Health Research Institute is focused on contributing to the body of scientific knowledge related to pharmacy and health care through research collaborations with external academic institutions, participation in federally-funded research, analysis and sharing of CVS Health data sources and coordination of pilot programs and initiatives. CVS Health Research Institute findings support a continuous quality improvement environment, which encourages product innovation and development to benefit CVS Health patients, clients and their members.