Pharmacy Aligns With Hospitals to Reduce Readmissions

Pharmacy giant Walgreens announced a program Tuesday that it believes will help hospitals reduce readmissions by using pharmacists to coordinate patient care during admission and discharge.

Hospitals are under the gun to lower readmission rates since the Centers for Medicare and Medicaid Services (CMS) started assessing financial penalties October 1.

At its core, Walgreen's program, called WellTransitions, lifts the burden of medicine reconciliation off of the patient, and off hospital staff.  Exact details about medications are easy for patients to forget, and nurses need the information to do a proper workup, says Joel Wright, Vice President of Health Systems Operations for the retailer.

"When a patient is admitted, we would be brought in, and we would help provide medication history, rather than starting with a blank sheet of paper. You know, my dad went in and he's like, 'Well, I'm on a blue pill for my water.' So, this gives that nurse a starting point to have that conversation with the patient to really understand what that patient is on," says Wright.

The effort doesn't stop there. Wright says when the patient is ready to be discharged, a Walgreens pharmacy staff member will make bedside deliveries of medications a patient will need to take home. After that, a clinician will follow up with regular phone calls to make sure the patient is taking medication properly, and see that an appointment has been made with their primary care physician.

"The goal of this is to be closer to the patient and be closer, as well, to the prescribers and… leverage those pharmacists to be more a part of the healthcare team and work more collaboratively and really even work with the system to help patients get, stay, and live well," says Wright.

There are about a dozen hospitals participating in the program now. The Walgreens wants to roll it out nationwide, and Wright says they're in the contract phase with "many" providers.

Sarasota Memorial Health Care System has been in partnership with Walgreens' WellTransitions program for over a year. Susan Gaillard, RN, a heart failure specialist for Sarasota Memorial says the program has had an "absolutely huge impact" at the hospital.

"I'm a heart failure nurse and my job is to counsel people on their heart failure and make sure that they have all the tools they need to take care of themselves. Medication noncompliance is a really big cause of readmission."

Gaillard said she had no hard data on how the pharmacy program affected its readmission rate, but another participating hospital, Washington Adventist Hospital in Takoma Park, WA. does, says Wright.

"We only took the high risk patients, so the patients they felt were most likely to readmit, and of the first 48, only three of them readmitted. If you just look at heart failure, for example, the national average around that would be 20 percent."

Retailers are expanding their role in the healthcare continuum. Retail pharmacy chains such as Walgreens and CVS, started moving closer to patients and providers years ago when they unveiled walk-in clinics. This month Wal-Mart announced that beginning in January 2013, it will pay for cardiac and spinal surgeries for its employees through a bundled payment arrangement with six hospitals.

Both Walgreens and Wal-Mart are promoting the programs as no additional costs to patients.

"WellTransitions does enter into an agreement with the health system, so the health system does participate, and it's all covered through the fee reductions or penalty reductions or avoidance through the Medicare healthcare reform," says Wright.

Acceptance of these programs from patients who recognize brands they trust may move the coordinated model of care forward.