Innovative care management models offer potential opportunities to expand medical laboratory testing services

Reducing hospital readmissions is a major goal and Walgreen Co. (NYSE:WAG) wants to do its part using a new medication management program. The retail pharmacy giant has entered contracts with about a dozen providers to deliver prescriptions to hospitalized patients and manage their medications for the first 30 days after discharge.

Pathologists and clinical laboratory managers know that preventable hospital readmissions cost the U.S. healthcare system approximately $25 billion per year. That figure was provided by a Walgreen’s press release. Among Medicare patients, about 20% are re-hospitalized within 30 days of discharge, the release stated.

“When a patient leaves the hospital with a new medication regimen, it can be overwhelming for both the individual and a caregiver,” observed Kermit R. Crawford, President, Pharmacy, Health and Wellness Division at Walgreens, in the release.

walgreen sign

To address the problem of hospital readmissions, Walgreens, the national pharmacy chain, is introducing a new model of integrated-care management. Walgreens is contracting with providers to deliver prescriptions to hospitalized patients and manage their medications for the first 30 days after discharge. This new service could be the inspiration for clinical laboratory pathologists to add value by providing consultative and care management services to physicians and patients in an effort to reduce hospital readmissions. (Photo copyright myfrugaladventure.com)

“Through this program, our pharmacists work closely with hospital staff to oversee medication therapies… providing the care patients need during their hospital stay, as well as after discharge.”

Innovative Pharmacy Services Model Could Improve Patient Outcomes

Walgreen’s program is called WellTransitions. It aims to shrink readmission rates through managing medication adherence, the press release reported. Lower readmission rates mean lower overall healthcare costs and improved patient outcomes.

WellTransition’s care management services will include:

  • reviewing patients’ prescriptions upon admission and discharge;
  • offering hospital-bedside delivery of medications to patients;
  • providing medication counseling to patients and their caregivers;
  • making regularly scheduled follow-up calls to discuss patient progress and medication-regimen adherence;
  • being available 24/7 to answer questions online or by telephone;
  • working with patients to assure they have scheduled an appointment with their primary care physician; and,
  • reinforcing self-care principles, such as checking weight daily and reporting significant fluctuations.

If Walgreen’s succeeds in helping hospitals to reduce 30-day readmissions, the hospitals could avoid costly Medicare penalties tied to such readmissions. According to Joel Wright, Vice President of Health Systems Operations at Walgreen’s, the company is negotiating with some of its collaborators to share in those savings, a story in Modern Healthcare (MH) reported. Under other contracts, Walgreens will receive fee-for-service payment for pharmaceutical management, MH stated.

Outcomes data on the pharmacy care management program is not yet available. However, hospital officials have acknowledged a trend of positive results.

Walgreens currently operates an outpatient pharmacy at more than 150 hospitals, the press release noted. It is targeting many of these facilities throughout the U.S. to roll out this new program.

Care Management Model Could Be Used for Clinical Laboratory Testing

Hospitals are under increasing pressure to deliver high-value care. For that reason, Walgreen’s program could be a forerunner of many innovative, cost-saving approaches to coordinated care, the MH story suggested.

For pathologists and clinical laboratory managers, it is not difficult to imagine the possibility of a national medical laboratory company adopting a similar collaboration model. What is to prevent the national clinical laboratory companies from developing relationships with national pharmacy chains to track patients’ medical laboratory testing needs at discharge and in the following weeks?

Through such a service, clinical laboratory companies could identify which patients have not gotten their ordered lab tests since discharge. They could also track patients whose post-discharge medical laboratory test results indicate that some clinical action or follow-up is required to help prevent readmission.

Like national pharmacy chains, large national clinical laboratories have the regional infrastructure to provide coordinated, integrated care-management services. A pharmacy and a clinical laboratory patient service center both are sites where a post-discharge patient could show up. Thus, a working collaboration between a pharmacy and a clinical laboratory that identifies patients failing to comply with their post-discharge regimen would be an innovative example of integrated clinical care. It could help the patient avoid falling into the gaps that currently exist between different types of healthcare providers.

 

—Pamela Scherer McLeod

Related Information:

Partnering up

Walgreens introduces WellTransitions, a coordinated care model that works in tandem with hospitals

Walgreens WellTransitions Provides Discharge Services to Help Hospitals and Health Systems Reduce Readmissions

Reducing readmissions: How 3 hospitals found success

Posted Feb. 7, 2011

;