Geisinger Health Plan reduced the relative risk of all-cause 30-day readmissions by 44 percent compared to a matched control group using an interactive voice response (IVR) system developed by AMC Health. The IVR system targeted patients who were at high risk for readmissions following a hospital discharge. Care managers identified those complex patients that were at high risk for post-discharge complications that could lead to a readmission, explained Dr. Maria Lopes, chief medical officer at AMC Health.
The IVR system makes one call per week for four weeks, using branching logic to identify issues with medication adherence, PCP follow-up, and complications, as well as a risk and falls assessment. The program is integrated into the care management workflow to make this impact, she added.