Telemedicine transitional care programs: effects on readmissions and patient experience

Abstract

Background: The integration of telemedicine within transition of care models has shown to be a promising solution in improving patient outcomes via its association with reduced 30-day hospital readmission rates. Yet little is known about how transition of care models impact hospitals’ Centers for Medicare and Medicaid Services (CMS’) 5-star quality rankings. As such, this study seeks to examine the associations telemedicine-integrated transitional care programs and quality metrics such as CMS transition of care star ratings and 30-day readmission rates for three measures: acute myocardial infarction (AMI), heart failure (HF), and all cause readmissions. Methods: Applying a cross-sectional study design, we collected data from the 2022 American Hospital Association Annual Survey, the CMS Hospital Readmission Reduction Program, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and Area Health Resource Files. Mixed effects modeling was employed to examine associations between telehealth post-discharge services, transition care star ratings, and 30-day readmission rates. Results: Hospitals with higher transition care star ratings had lower 30-day readmission rate for HF (3-star: −0.89, 4-star: −0.97, 5-star: −0.96; p < 0.001) and for all-case readmission rate (3-star: −0.30, 4-star: −0.40, 5-star: −0.48; p < 0.001). However, for AMI 30-day readmissions, only 4-star transition of care hospitals reported statistically significant reductions (−0.34, p < 0.05). Our findings show that telehealth-integrated post-discharge services was associated with lower 30-day HF readmission rate among 2-star rated hospitals only (−0.32, p = 0.024), no other associations were found. Conclusion: Our findings show that hospitals with higher CMS care transition ratings are associated with positive quality outcome improvements in 30-day AMI, HF, and all cause readmissions, however, the association between hospitals with telehealth services and quality outcomes varied based on facility rating and condition type. This suggests that strategies to integrate telehealth into the care transition process should consider care transition quality rankings and organizational factors such as market competition.