Effectiveness of Transitional Care Program among High-Risk Discharged Patients: A Quasi-Experimental Study on Saving Costs, Post-Discharge Readmissions and Emergency Department Visits

Moonseong Heo, Kevin Taaffe (), Ankita Ghadshi, Leigh D. Teague (), Jeffrey Watts, Snehal S. Lopes, Peter Tilkemeier and Alain H. Litwin
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Moonseong Heo: Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
Kevin Taaffe: Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA
Ankita Ghadshi: Department of Industrial Engineering, Clemson University, Clemson, SC 29634, USA
Leigh D. Teague: Department of Medicine, Prisma Health, Greenville, SC 29605, USA
Jeffrey Watts: Value-Based Care & Network Services, Prisma Health, Greenville, SC 29605, USA
Snehal S. Lopes: Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
Peter Tilkemeier: Department of Medicine, Prisma Health, Greenville, SC 29605, USA
Alain H. Litwin: Department of Medicine, Prisma Health, Greenville, SC 29605, USA

IJERPH, 2023, vol. 20, issue 23, 1-15

Abstract: Transitional care programs (TCPs), where hospital care team members repeatedly follow up with discharged patients, aim to reduce post-discharge hospital or emergency department (ED) utilization and healthcare costs. We examined the effectiveness of TCPs at reducing healthcare costs, hospital readmissions, and ED visits. Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement (BPCI) program adjudicated claims files and electronic health records from Greenville Memorial Hospital, Greenville, SC, were accessed. Data on post-discharge 30- and 90-day ED visits and readmissions, total costs, and episodes with costs over BPCI target prices were extracted from November 2017 to July 2020 and compared between the “TCP-Graduates” (N = 85) and “Did Not Graduate” (DNG) (N = 1310) groups. As compared to the DNG group, the TCP-Graduates group had significantly fewer 30-day (7.1% vs. 14.9%, p = 0.046) and 90-day (15.5% vs. 26.3%, p = 0.025) readmissions, episodes with total costs over target prices (25.9% vs. 36.6%, p = 0.031), and lower total cost/episode (USD 22,439 vs. USD 28,633, p = 0.018), but differences in 30-day (9.4% vs. 11.2%, p = 0.607) and 90-day (20.0% vs. 21.9%, p = 0.680) ED visits were not significant. TCP was associated with reduced post-discharge hospital readmissions, total care costs, and episodes exceeding target prices. Further studies with rigorous designs and individual-level data should test these findings.

Keywords: post-discharge care; transitional care program; cost; hospital readmission; ED visits (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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