How One Point-of-Care Strategy Cuts Readmissions

The services provided included:

• Appointment scheduling and reminders
• Follow up for missed appointments
• Needs assessment for community services
• Skills for communicating with healthcare providers
• Indentify red flags for readmission
• Indentify barriers to meeting treatment or medication plans
• Medication reconciliation

The baseline group had a 30-day readmission rate of 17%, which Gillespie says is consistent with the industry average. The readmission rate for the pilot group was 12%. The total number of readmissions per member was reduced by almost 37% and the total number of hospitalized days was reduced by 43%.

The total cost of those readmissions for the base group was $673,103. For the intervention group the cost was $640,505. The $32,598 cost differential was more than enough to cover the monthly salaries and benefits of the five-member intervention team.

Although EmblemHealth set out to measure the effect on hospital readmissions, the intervention team’s physical presence in the physician office produced other, unanticipated advantages.