Research Finds Discharge Pharmacy Programs Can Reduce Hospital Readmission Rates

Hospital readmission rates have plagued the United States health care systems for decades. Rehospitalization negatively impacts health care systems, resulting in financial burdens, reduced patient satisfaction, and strains on resource allocation. In 2011, the national average hospital readmission rate hit a staggering 18.4%, catalyzing a potent overhaul designed by the Centers for Medicare and Medicaid Services (CMS).¹

Hospital readmission rates have plagued the United States health care systems | Image credit: Monkey Business | stock.adobe.com

CMS introduced the Hospital Readmissions Reduction Program (HRRP) in 2012, a policy that penalizes hospitals for poor readmission performance. HRRP specifically focuses on risk-standardized unplanned readmissions within 30 days of the initial hospitalization, regardless of where the rehospitalization occurs. The program incentivized hospital systems to emphasize reducing rehospitalizations, resulting in an uptick in transitional care services, including bedside medication delivery and discharge medication reconciliation. By 2022, the national average hospital readmission rate decreased by over 20%.¹

Discharge pharmacy programs, colloquially known as meds-to-beds programs, are becoming a staple of integrated health care delivery models. Providing prescribed medications to patients before discharge has generated several positive outcomes in studies, including improved medication adherence rates, elimination of medication issues at discharge, increased revenue for hospital systems, and reduced rehospitalization rates. Unfortunately, most available literature thus far focuses on smaller healthcare settings.

Ascension Seton, a large health care system in central Texas, designed a thorough assessment of their discharge pharmacy initiative to determine its efficacy, potential scalability, and impact on hospital readmissions. The multicenter, retrospective cohort study considered adult patients aged 18 years or older discharged from inpatient units at 4 Ascension Seton hospitals receiving at least 1 prescription. The patients were asked to designate their preferred pharmacy for discharge prescriptions, with the hospital-based Ascension pharmacy as a potential option.²

Choosing the Ascension pharmacy allowed for onsite services, including insurance coverage troubleshooting (ie, prior authorization requests), identifying alternatives for high-cost medications, and personalized patient counseling. The study’s primary outcome was the 30-day hospital readmission rate within the health system for patients who elected to receive their prescriptions from one of the centralized outpatient pharmacies compared to the non-Ascension pharmacy group. Secondary outcomes included readmission rates within 31 to 60 days of the initial visit and additional analysis of the primary diagnosis resulting in rehospitalization.²

The average 30-day hospital readmission rate related to the initial hospital visit was found to be statistically significantly lower in the Ascension pharmacy group compared to the non-Ascension pharmacy group. The Ascension pharmacy group also had lower rates of readmission at 31 to 60 days, but the difference was not statistically significant.²

The study results highlight the key advantages of implementing integrated health care models that include a pharmacy discharge program. By ensuring medication access before the patient leaves the hospital, the incidence of medication errors and nonadherence inherently decreases. A decreased rate of hospital readmissions results in reductions in spending on both the direct costs of inpatient care and the potential penalties imposed by CMS due to high readmission rates.²

As health care systems continue to adapt to a constantly changing landscape, the implementation of hospital-based discharge pharmacy services presents a savvy strategy to improve clinical outcomes for patients while simultaneously cutting excess spending.

REFERENCE

1. Gerhardt G, Yemane A, Hickman P, Oelschlaeger A, Rollins E, Brennan N. Medicare readmission rates showed meaningful decline in 2012. Medicare Medicaid Res Rev. 2013;3(2):mmrr.003.02.b01. doi:10.5600/mmrr.003.02.b01

2. Robarts E, McGinnis B, Nguyen B, Pan N, Ong E. Impact of obtaining prescriptions upon discharge on hospital readmissions in a large healthcare system. Am J Health-Syst Pharm. 2025;zxae395. doi:10.1093/ajhp/zxae395