Medication adherence strategies for lowering hospital readmission rates

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Bill Shields
Bill Shields

Nearly one in five Medicare patients return to the hospital within a month of discharge, costing the Centers for Medicare and Medicaid Services (CMS) an extra $17.5 billion in 2010[i].

According to CMS, this won't go on much longer.

The Hospital Readmission Reduction Program, a signature program of the 2010 Patient Protection and Affordability Care Act, kicked off on October 1, 2012 and threatens U.S. hospitals with diminished CMS reimbursements for high readmission rates.  

A Closer Look at the Readmissions Reduction Program

The Hospital Readmissions Reduction Program reduces payments to hospitals that excessively readmit patients suffering from acute myocardial infarction, heart failure and pneumonia—three conditions with the infamously highest 30 day readmissions rates.

A total of 2,217 hospitals are expected to be penalized in the first year of the program. Of those, 307 will be docked the maximum amount: 1% of their regular Medicare reimbursements. The penalty will jump to 2% in 2014 and 3% in 2015.[ii]

CMS estimates that 11% of hospital readmissions occur due to medication non-adherence, creating an economic impact that is estimated to cost nearly $100 billion annually.[iii] In order to avoid leaving money on the table, hospitals and the healthcare industry must address the medication adherence challenges that are driving up readmission rates.

Replacing Pill Bottles With Advance Packaging Solutions

Multi-medication packaging solutions aggregate all of a patient's daily medications into small, portable and easy-to-use punch cards, typically segmented in a calendar format for easy use. With the average patient over age 55 taking somewhere between six to eight medications daily[iv], American multi-med packaging solutions like RxMap® by MTS Medication Technologies ensure that patients are adhering to their medication regimens and avoiding repeat trips to the hospital. The adherence epidemic not only affects readmissions, as failed consumption of medication can often be the first sign of declining health among senior citizens. In fact, the USC Arnold School of Public Health estimates that 23% of all initial admissions in nursing homes are due to medication non-adherence. [v]

These patient-friendly solutions ease the challenging transition many patients face when they move from long-term care to home treatment that lacks constant medical supervision. The improved rates of compliance are undeniable with blister packs. A 14-month study from the American Heart Association reported that patients' medication compliance rose from 61% to 96% when using multi-med packaging solutions instead of pill bottles[vi]

Conclusion

A significant proportion of hospital readmissions are caused by medication-related adverse events. One study found that one-third of adverse drug events resulting in a hospital admission were related to non-adherence[vii]. As the urgency for reducing readmissions increases, multi-med packaging solutions could very well “punch out” all three of these challenges, all bundled into one easy answer.

Bill Shields is the executive vice president, Non-Acute Care, Omnicell, Inc.



[i] "National Medicare Readmission Findings: Recent Data and Trends." . Centers for Medicare & Medicaid Services, n.d. Web. 10 Oct 2012. <http://www.academyhealth.org/files/2012/sunday/brennan.pdf>.

[ii] Rau, Jordan. "Medicare To Penalize 2,217 Hospitals For Excess Readmissions." Kaiser Health News. N.p., 12 2012. Web. 30 Oct 2012. <http://www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.asp&xgt;

[iii] Osterberg, L., Blaschke, T. (2005). Adherence to medication. N Engl J Med, 353(5), 487-497. 

[iv] Span, Paula. "A Dose of Confusion." N.p., 15 June 2011. Web. 10 Oct. 2012. <http://newoldage.blogs.nytimes.com/2011/06/15/a-dose-of-confusion/>. 

[v] . "Medication Adherence Management Service." . USC Arnold School of Public Health. Web. October 10, 2012. <http://www.sph.sc.edu/osa/MedicationAdherenceManagementService.htm>.

[vi] Krumholz, Harlan. "Journal Watch Cardiology." Journal Watch Cardiology. November (2006): n. page. Web. 31 Oct. 2012. <http://cardiology.jwatch.org/cgi/content/full/2006/1113/2>.

[vii] McDonnell PJ, Jacobs MR. Hospital admissions resulting from preventable adverse drug reactions. Ann Pharmacother. 2002 Sep;36(9):1331-6. PubMed PMID: 12196047

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