title: An Insurer's Care Transition Program Emphasizes Medication Reconciliation, Reduces Readmissions And Costs.
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.
authors.affiliation: Jennifer M. Polinski (jennifer.polinski@cvscaremark.com) is a senior director at CVS Health in Woonsocket, Rhode Island.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Polinski
authors.affiliation: Janice M. Moore is a senior adviser at CVS Health in Northbrook, Illinois.
authors.forename: Janice M
authors.initials: JM
authors.lastname: Moore
authors.affiliation: Pavlo Kyrychenko is a senior manager at CVS Health in Northbrook.
authors.forename: Pavlo
authors.initials: P
authors.lastname: Kyrychenko
authors.affiliation: Michael Gagnon is a senior consultant at CVS Health in Cumberland, Rhode Island.
authors.forename: Michael
authors.initials: M
authors.lastname: Gagnon
authors.affiliation: Olga S. Matlin is a senior director at CVS Health in Northbrook.
authors.forename: Olga S
authors.initials: OS
authors.lastname: Matlin
authors.affiliation: Joshua W. Fredell is a senior director at CVS Health in Northbrook.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Fredell
authors.affiliation: Troyen A. Brennan is chief medical officer at CVS Caremark, in Woonsocket.
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.affiliation: William H. Shrank is chief scientific officer and chief medical officer for health systems alliances at CVS Health in Woonsocket.
authors.forename: William H
authors.initials: WH
authors.lastname: Shrank
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000191:economics; D017046:Cost Savings; D003695:Delivery of Health Care / Q000458:organization & administration*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007343:Insurance Carriers / Q000191:economics*; D008297:Male; D059065:Medication Reconciliation / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data; D010360:Patient Transfer; D010595:Pharmacists; D024382:Professional Role; D057216:Propensity Score; D014481:United States
keywords: Health Spending; Medicare; Organization and Delivery of Care; Quality Of Care