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Maintaining Quality and Improving Outcomes During Care Transitions

February 16, 2017 | Health And Wellness Products

For seniors and those with chronic medical conditions, it’s not uncommon to experience transitions from one care setting to another, such as to and from hospitals, assisted living facilities and an individual’s home. With each transition comes prescriptions, paperwork, instructions, and too often, confusion for patients.

Without proper care coordination and medication management, this confusion leaves transitioning patients vulnerable to drug interactions, unpleasant medication side effects, and serious adverse events that can lead them back to the hospital. In fact, one in seven patients discharged from a hospital is readmitted within 30 days, creating a heavy cost burden on the health care system:

  • Hospital readmissions are associated with more than $41 billion in additional health care costs per year.

  • 66 percent of these readmissions are related to preventable adverse health events, such as medication non-adherence.

Transitions Can Be Overwhelming

When a patient is discharged from a hospital or other care facility, it is typically treated like an ending – bags are packed and lists are checked, yet it is actually the beginning of a new phase of care.

For example, many patients’ health issues are not fully resolved at the time of their departure, so in the coming weeks and months, they must focus on recovery, while balancing new and unfamiliar medicines, lifestyle changes, and outpatient follow-up. This can be challenging for even the most well-equipped and health literate of patients, not to mention those facing more serious physical, mental health or financial challenges.

Too often, breakdowns in communication, patient education, or accountability can lead to ineffective transitions in care, and leave patients unclear about or ill-equipped to manage their new care plan and medications.

Pharmacists Are Valuable Partners During Transition

Pharmacists can be particularly helpful during care transitions by fostering communication and driving medication adherence:

  • 60 percent of all medication errors occur while patients are transitioning out of a hospital, and 72 percent of post-discharge adverse events are medication-related. By offering a broad set of health services, including counseling, screening and medication reconciliation, and serving as an accessible touch-point for patient questions, pharmacists are well-positioned to address the confusion that comes with a care transition, and can help reduce these preventable medication errors.

  • A recent study by researchers at the CVS Health Research Institute published in Health Affairs found that pharmacist-led medication reconciliation programs following a hospital stay reduced the risk of hospital readmission at 30 days by 50 percent. This also led to lower costs for the health plan, which saved $2 for every $1 spent on the program, representing a total savings of more than $1,300 per member.

  • Pharmacists can also use and promote digital tools, such as medication reminders and prescription-filling apps, to improve communication and compliance among patients. For example, our ScriptSync program enables patients and caregivers with multiple maintenance medications to pick up all of their eligible prescriptions at the same time in a monthly CVS Pharmacy visit. This program, which now has more than one million enrolled patients, has proven to increase medication adherence by five to ten percent.

Committed to Improving Transitions

CVS Health’s partnerships and subsidiaries have expanded our offerings to more patients, improving quality and accessibility for individuals who experience care transitions:

  • CVS Health subsidiary Omnicare supports the transitions of more than one million seniors at long-term care facilities through pharmacy and medication reconciliation services. The goal is to reduce readmission rates and promote enhanced health outcomes.

  • Coram in-home infusion services support patients who are managing a range of acute and chronic conditions requiring intravenous therapy, including immune deficiencies, rheumatoid arthritis, multiple sclerosis, and nutritional deficiencies caused by chronic conditions, such as cancer.

For more information about how CVS Health is working to transform the health care experience, visit our Health Care Delivery & Innovation information center.