“Meds-to-Beds” programs aim to improve patient engagement, tackle readmission problem

By providing patients with one-on-one pharmacy support before they are sent home, these programs can improve engagement and help reduce the high number of hospital readmissions that occur due to post-discharge medication errors.

Money is like Medicine drug costs

A growing number of U.S. hospitals are launching transition-of-care pharmacy services to improve patient engagement and outpatient medication adherence as part of an overall strategy to reduce 30-day hospital readmissions.

By providing patients with one-on-one pharmacy support to make sure they understand how to take their medications, the possible side effects, and their costs, these “meds-to-beds” programs can help reduce the high number of hospital readmissions that occur due to post-discharge medication errors, particularly among high-risk patients with chronic conditions that require multiple prescriptions.

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Non-adherence, medication misuse, and missed refills are common reasons why 15 to 25 percent of hospital patients are readmitted within 30 days of discharge. Patients with chronic conditions have even higher readmission rates. This year, those readmissions will cost hospitals $528 million in lost Medicare revenue due to the Affordable Care Act’s 30-day penalty for readmissions associated with certain conditions, according to estimates by the Henry J. Kaiser Family Foundation.

Meds-to-beds programs are aimed at reversing this trend. Upon admission, a clinician or patient education video explains the program to each patient and provides the patient with an opportunity to opt in. Prior to discharge, a pharmacist or qualified clinician meets with the patient to provide counseling and assess the patient’s understanding of his or her new medications.

Patients also receive information about their drug treatment costs. Studies show that one in five new prescriptions go unfilled, often because the patient can’t afford to fill them. If a patient has financial constraints that could prevent the individual from obtaining refills, pharmacists and case managers work to identify financial assistance programs, such as copay reductions, free trial cards, and price matching.

Anecdotally, hospitals have reported positive feedback from patients regarding the programs. Many say they appreciate the convenience of receiving all of their medications before leaving the hospital, thereby skipping a trip to their retail pharmacy on a day when most patients are looking forward to returning home.

Some hospitals that have implemented “meds-to-beds” programs include Children’s Mercy Hospitals and Clinics, Swedish American Hospital, and Tampa General Hospital.

A strategy that prepares patients for more complex drug therapies
By implementing these best practices now, healthcare organizations will be better positioned to support the rising number of patients receiving specialty drugs—complex, expensive drug therapies that are designed to treat such chronic or genetic diseases and disorders as cancer, multiple sclerosis and Hepatitis C.

Spending on these types of medicines nearly doubled between 2010 and 2015, and contributed more than two-thirds of overall medicine spending growth. Some analysts predict that specialty drugs will account for up to 50 percent of all U.S. medication spending within the next three years.

Implementing strategies to help patients understand how to take these therapies, manage their uncomfortable side effects and obtain assistance paying for them can help prevent the 30-day rehospitalizations that are common among patients who either misuse or fail to take these treatments as prescribed.

One welcome side-effect: Increased revenue
Hospitals and health systems who have implemented a meds-to-beds program are also reporting increased revenue. One healthcare system with 900 locations doubled its pharmacy revenue over four years after implementing on-site discharge prescriptions at just two of its locations. The organization plans to further expand the program to additional campuses.

And an adult acute-care hospital with 17,000 admissions per year increased its outpatient pharmacy revenue by 32 percent, to $3.2 million over three years.

Photo: Devrimb, Getty Images