For Joanne Barrs, having medication delivered to her room at DeKalb Medical after a surgery in September was a surprising convenience.
The 63-year-old from Stone Mountain didn’t have to sit in the car in pain as her husband waited in line at a pharmacy to fill her prescription. Instead, a Walgreens employee came by with the pain medication before Barrs left the hospital – just 20 minutes after nurses called it in.
“It was a great convenience for us,” she said, especially since her husband’s time is often limited because of his job. “He has little to no patience waiting for things like that.”
In a push to improve patient satisfaction, a growing number of hospitals are teaming up with Walgreens pharmacists to offer one-on-one consultations before patients leave the hospital – delivering drugs to their bedsides and making sure they understand new medications.
At DeKalb Medical, which started the program in July, patient satisfaction rates related to communication about medication rose from 50 percent to 63 percent in the first three months and are continuing to climb.
Both DeKalb Medical and the drugstore chain have a bottom-line interest in the partnership. Improving patient experience and overall quality of care will be increasingly important factors in how much hospitals are paid as new federal guidelines roll out over the next couple of years. Walgreens gets a built-in customer base at the hospital and a chance to win them longer-term.
For patients, that means more personal attention and help understanding how and when to take new drugs, as well as which might conflict with what they’re already taking at home. Such programs improve patient satisfaction and also lower health care costs by ensuring people stay healthy and don’t end up back in the hospital, industry observers say.
One of the main reasons people are readmitted to the hospital is because they don’t follow their medication regiments, said Dr. Solomon Tafari, DeKalb Medical’s program medical director. Nationwide in 2009, avoidable hospital readmissions cost $26 billion for Medicare alone.
Walgreens has informally rolled out variations of the voluntary bedside medication delivery program to 100 pharmacies it runs on hospital campuses, including Atlanta Medical Center and Piedmont Hospital. It remains to be seen how widely the idea is adopted by hospitals or other drugstore chains.
At DeKalb, pharmacy employees also call patients within 72 hours of discharge to answer questions about medications, potential side effects and treatment programs.
The bedside delivery service is added on as part of the prescription filling process at no cost to patients or hospitals, said Ron Weinert, Walgreens' vice president of health systems services. The company also has a more extensive pilot program -- that comes at a cost to hospitals -- to make sure patients’ old and new drugs don’t conflict by closing older prescriptions that can’t be refilled, Weinert said.
Walgreens is seeing positive early results in reducing readmissions because of the counseling, Weinert said.
“It’s really a behavioral thing,” he said. “The goal is really to educate the patient.”
It’s often hard for patients to remember medication instructions once they get home, said Austin Mudd, pharmacy manager at the DeKalb Medical Walgreens. Sometimes people also just don’t know what their medications are for, and it helps to explain how each drug helps, Mudd said.
“If you know your reason for it, you’re more apt to take it,” he said, adding that while it would be great if patients chose to stick with Walgreens, they also work with people to transition to their regular pharmacies.
The unexpected service improves patient satisfaction, but it also allows the hospital to sniff out potential problems with medications before patients leave, said Matthew Schreiber, chief medical officer at Piedmont Hospital. Someone who may not realize they have a $500 co-pay may show up to a pharmacy to get it filled, see the price tag and walk away, he said. The Walgreens pharmacy on campus can find that out in advance and identify a similar but more affordable drug and get approval from the doctors, Schreiber said.
Many drugs also require preauthorizations, a big hurdle for patients that the pharmacy can deal with, he said.
Many patients on Medicare have chronic diseases and often have four or five medications, said David Hefner, executive vice president of clinical affairs at Georgia Health Sciences University. As people get older, there’s a higher likelihood of ending back up in the hospital, so hospitals and other medical providers are finding they must work together to provide better integrated care, Hefner said.
The challenge is “How . . . we link and bond with other providers and the patient and family members to wire together that continuum of care that helps the patient manage their condition outside the walls of the hospital,” he said.
If hospitals don’t reduce 30-day readmissions and improve quality of care, they could risk losing millions of dollars in federal funding in the coming years. Starting in fiscal 2013, hospitals could face a 1 percent penalty of their total Medicare funding, followed by 2 percent in 2014 and 3 percent in 2015 if readmission rates are too high.
Patient satisfaction and quality of care measures will also affect how providers are paid in the future as Medicare shifts from reimbursing providers for every service to paying based on performance.
In fiscal 2013, Medicare will shift an estimated $850 million from fee-for-service payouts and allocate it based on performance -- a move that could hurt hospitals with poor patient reviews.
Patient experience will also be key in hospitals differentiating themselves, Tafari said. When people come to DeKalb, they need to feel like the center of attention, he said. “That will be our competitive advantage to win these patients."
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