University of Pa. Health System, Independence Blue Cross see fewer hospital readmissions

Independence Blue Cross recently announced that the first year of a five-year initiative between the insurer and the University of Pennsylvania Health System (UPHS) resulted in a more than 25 percent reduction in preventable hospital readmissions.

The initiative aimed to reduce the number of patients who return to the hospital within a month of going home through various innovations. Under the contract with UPHS, Independence wouldn’t pay for the resulting hospitalization in those cases.

“To see such a drastic improvement just one year into our partnership with Independence serves as a great motivator to continue finding ways to bend the curve of rising health care costs,” Ralph W. Muller, CEO of the University of Pennsylvania Health System, said. “That can only happen if we work together to keep patients healthier, and in the first year of our new model, we’re proud to have shown that we can achieve both goals.”

Many factors contribute to a patient’s likelihood of being readmitted, Independence said, including disease progression, complications or infections, emergency room visits for management of chronic conditions and miscommunication between patients or caregivers and medical teams regarding discharge instructions.

At the beginning of the initiative, Penn Medicine used its electronic health record platform to identify patients at high risk of readmission. New electronic medical record functions provided medical professionals with access to real-time insights on each high-risk patient, which helped clinicians to take proactive steps to reduce readmissions.

For some patients with complex medication regimens, for example, these steps included the use of pre-packaged medication boxes to remotely monitor and ensure patients took their medications as prescribed. Another measure involved schedulers calling patients at high risk of readmission and assisting them in setting up their follow-up outpatient appointments.

“These results are phenomenal and prove just how much we can achieve if we innovate together on purposeful programs to improve patient and member care,” Daniel J. Hilferty, president and CEO at Independence Blue Cross, said. “We hope our experience reinforces to others in the health care field how important it is to work together to find solutions that can positively impact the quality and coordination of care and fight rising health care costs for patients and members.”