Health Systems

A Prescription for Reduced Readmissions


Extending the Role of Medication Management in Transitions of Care

As the focus on value-based care foreshadows even greater demand from hospitals and health systems Empowered Care Sidebaracross the nation, many organizations are looking within their current transitional care process to identify where they can make the greatest impact to improve patient outcomes and reduce preventable readmissions. Their point of convergence: medication management.

Medications are involved in 80 percent of all treatments, opening the door to a non-adherence rate that costs the U.S. healthcare system upward of $290 billion annually.1 In fact, almost 70 percent of readmissions involve a medication error or adverse drug effect.2 And while chronic conditions account for about 75 percent of all U.S. healthcare expenditures, of which medications play a huge role, reports indicate up to 50 percent of these patients do not adhere to their prescribed drug therapy.3 It's numbers like these that make the case for implementing comprehensive medication management, which in addition to improving cost efficiencies and patient outcomes, will also help to set a foundation on which the enterprise can build best-in-class transitional care.

While traditional care is linear in its approach to the patient, we are now seeing a more fluid process. 

While traditional care is linear in its approach to the patient, we are now seeing a more fluid process. Care needs to surround the patient - reacting and proactively engaging, inquiring and interacting with the patient to enlist them as an active participant in their treatment regimen and drive the best clinical outcome. From the very first interaction with the patient, the hospital or health system should be setting that patient up for success on the back end:

  • Reconciling drugs when the patient arrives and before he or she is discharged 
  • Ensuring the patient leaves the facility with a 30-day supply
  • Confirming the patient's ability - financially and physically - to get a refill of the exact drug therapy prescribed
  • Touching base at critical junctures post-discharge, considered to be 24 hours, 72 hours, 15 days, and 25 days 

While all these elements play an integral part in reducing readmissions, many hospitals and health systems don't have the resources to allocate to medication management at this level - especially as it relates to executing follow-up once the patient leaves the hospital. That fundamental shift into the outpatient world is where the bulk of the work resides for most organizations.

Expanding the Eco(Health)system
No one hospital or health system is uniquely positioned in all areas to be prepared for such a heavy undertaking. That's why internal and external collaborations are key. While forward thinkers within the healthcare industry are already extending medication management through ambulatory pharmacies and concierge care services, many are still clinging to fee-for-service, not addressing the shift to measure success against outcomes and reduced readmissions. And with that comes challenging perceptions about potential partners who may have previously been viewed as competitors, such as community pharmacies and practices.

Hospitals and health systems can boost patient outcomes while serving as a conduit for community health when the coordination of care extends beyond the walls of the health system. Patients receive consistent drug therapy in an off-site location that is convenient for them, while getting the added value of face-to-face time with a medical professional who can assess their progress on an ongoing basis.

Troubleshooting the Generational Glitch
In addition to shifting paradigms around collaboration in the community, hospitals and health systems have to contend with the challenges of younger generations. The majority of this particular audience isn't looking for long-term or even short-term care within a hospital or health system setting. In most cases they're not looking past their smartphones. With appointment apps, access to telemedicine solutions and a prevalence of private care facilities, hospitals and health systems must extend past their comfort zone and reach beyond their walls - not only to bridge the necessary gap in medication management, but perhaps eventually, to reach a new patient base.

Incorporating comprehensive medication management is key for hospitals and health systems to thrive in today's patient-driven, value-based care environment. And while part of building successful medication management may start with dissolving outdated notions, it's a move that seems inevitable based on the pace of industry innovation and a changing patient perspective.

Learn more about implementing successful transitions of care and how population health management drives health system decision-management.

1 "Medication Management." Medication Management. N.p., n.d. Web. 12 Oct. 2015; "Thinking outside the pill box: A system-wide approach to improving patient adherence for chronic disease." NEHI. 2009
2 American Pharmacists Association and American Society of Health-System Pharmacists. Improving Care Transitions: Optimizing Medication Reconciliation. March 2012. Available online at Accessed 9 December 2014.
3 American Society of Health System Pharmacists Report of the 2012 ASHP task force on accountable care organizations. Am J Health Syst Pharm. 2012:69:e56-66; Academy of Managed Care Pharmacy. Pharmacists as vital members of accountable care organizations. 

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