Cigna Study: Post-Hospital Discharge Outreach Reduces Readmissions 22 Percent for High Risk Gastrointestinal, Heart and Lower Respiratory Patients

Wed Jan 2, 2013 10:00am EST

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BLOOMFIELD, Conn.--(Business Wire)--
Arandomized 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." 

About Cigna

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, visitwww.cigna.com.

Cigna Corporation
Joe Mondy, 860-226-5499
Joseph.Mondy@cigna.com



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