A Cigna study shows case managers' outreach can help reduce some hospital readmissions.
BLOOMFIELD, Conn., January 02, 2013 - A randomized control study of 3,988 high-risk gastrointestinal, heart or lower respiratory patients by global health service company Cigna (NYSE:CI) found that prioritized, telephonic outreach by health plan case managers following hospital discharge reduced future readmissions by 22 percent. The results of the study are published in the December 2012 issue of the independent, peer-reviewed American Journal of Managed Care.
The Cigna study found that telephonic outreach by health plan case managers within 24 hours of hospital discharge resulted in more physician visits and prescription drug fills following initial discharge and a 22 percent lower hospital readmission rate. The study suggests that the key factors that help reduce hospital readmissions are prioritizing the timing of telephone outreach based on the discharge date and severity of the case.
“Readmissions of high-risk patients make up a significant portion of health care expenses -- accounting for 30 percent of total inpatient costs for private employer health plans,” said Cigna Senior Medical Director, Dr. Charles Foreman. “The lesson learned from the Cigna study is that the timing and prioritizing of readmission intervention to high-risk patients is critical. Prioritizing telephone outreach to high-risk patients based on their discharge date and risk severity significantly reduces the likelihood of 60-day readmissions.”
Cigna conducted a prospective, randomized control study of the effect of hospital discharge planning from health plan case managers on readmissions for high-risk patients. High risk was defined as having an initial discharge major diagnosis of gastrointestinal, heart or lower respiratory and length of stay of three days or more. An intervention group of 1,994 patients received telephonic outreach and engagement within 24 hours of discharge and their calls were made in descending risk order to engage the highest risk first. A control group of 1,994 patients received delayed telephonic outreach and engagement 48 hours after discharge notification and no call order by risk was applied. Comparison groups had statistically equivalent characteristics at baseline.
The intent-to-treat 60-day readmission rate for the treatment group was 7.4 percent versus 9.6 percent for the control group, representing a 22 percent relative reduction in all-cause readmissions. Two post-hoc assessments were conducted to identify potential mechanisms of action for this effect and showed the treatment group had more physician visits and prescription drug fills following initial discharge.
Looking ahead, Cigna's Dr. Foreman said, “Healthcare organizations providing post-discharge telephonic outreach to patients with diagnoses related to heart, gastrointestinal and lower respiratory can use these findings to inform the alignment of their case management resources.”
He added: “Further study needs to be done to test the prioritization intervention against all major diagnoses to confirm this approach impacts a wider profile of patients.”
Cigna Corporation (NYSE: CI) is a global health service company dedicated to helping people improve their health, well-being and sense of security. All products and services are provided exclusively through operating subsidiaries of Cigna Corporation, including Connecticut General Life Insurance Company, Cigna Health and Life Insurance Company, Life Insurance Company of North America and Cigna Life Insurance Company of New York. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy and vision care benefits, and other related products including group disability, life, and accident coverage. Cigna has sales capability in 30 countries and jurisdictions, with approximately 70 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.