Solving high readmission rates with outpatient pharmacy

When I used to think about patients not taking their prescriptions, I would immediately picture a fussy toddler, fighting some less than desirable medication. Today, I see patients newly released from the hospital, not even bothering to pick up their medications. Instead, they walk straight past the outpatient pharmacy and head home, only to be readmitted when they fail to comply with post-discharge instructions.  

Today, the burden of this seemingly cavalier behavior is being placed squarely on the shoulders of hospitals themselves as Medicare reimbursements are cut for hospitals with high 30 day re-admittance rates.  In October of 2012, the first round of penalties came crashing down, impacting over 2,000 hospitals with a combined loss of Medicare funds totaling more than $280 million. Although recent revisions have reduced the penalty for some hospitals, maximum penalty amounts are expected to increase next year, making it more important for hospitals to find ways to minimize readmission rates and maximize patient adherence.  

Hospital outpatient pharmacies must play a key role in any plan to conquer high readmission rates and defeat medication apathy.  Pharmacies that once saw a staggeringly low percentage of prescriptions written at the hospital actually filled at the outpatient pharmacy must change the game and develop methods to ensure that patients have a higher chance of complying with post-discharge instructions.  Finding ways to encourage patients to comply, and moreover, make it easy to obtain medications, will be of paramount importance as hospitals look to lower readmission rates and reduce spending.  A recent article from Forbes cites that just a 1% bump in filled prescriptions would make a significant dent in the over $2 trillion spent by Medicare in hospitalizations each year.

Programs are now starting to emerge that tie the pharmacy into the discharge process with bedside delivery of medication.  Patients receive their prescriptions and counseling before they leave the hospital.  This not only solves the biggest problem of patients not ever picking up their medication, but also alleviates the potential problem of counseling and instructions being lost in translation if a caregiver picks up the patients prescription from another pharmacy. It also can’t hurt that filling more prescriptions will increase outpatient pharmacy revenue and bedside delivery will improve the overall patient experience.

So we know what the problem is, and we know that there are ways to fix a significant portion of that problem. The question now is how to implement a successful program.  The answer is to look to new technologies to implement an easy to use comprehensive solution that will allow full processing of the discharge transaction right at the patient’s bedside.  This is exactly what we had in mind at RMS when our EvolutionPOS handheld register was first conceived.  Pharmacists and technicians can run a complete transaction at discharge, including scanning the prescription, accepting signatures, logging patient counseling and processing payment.   Growing numbers of hospitals are turning to this solution to implement a discharge program of their own. To find out more about how one such hospital is using the EvolutionPOS technology to its advantage, check out our case study on the new program at Huntsville Hospital.

At RMS, we expect bedside discharge programs to be the norm in the very near future.  If you’d like to find out how we can help your hospital’s outpatient pharmacy become a part of the solution for avoiding Medicare reimbursement penalties, please don’t hesitate to contact us.  An investment in technology today can help put your pharmacy on the cutting edge and increase your revenue in the long run, while minimizing the chance of patient readmmission.