Well Transitions Reducing Preventable Readmissions Walgreens Mission and

Well. Transitions® Reducing Preventable Readmissions

Walgreens Mission and Vision MISSION To be the most trusted, convenient multichannel provider/advisor of innovative pharmacy, health and wellness solutions, and consumer goods and services in communities across America… A destination where health and happiness come together to help people get well, stay well, and live well. VISION To be “My Walgreens” for everyone in America, the first choice for health and daily living

Transforming Community Pharmacy – Integrated Healthcare Delivery System A premier provider of healthcare and wellness services • 75, 000 healthcare providers deliver high-quality healthcare services – Retail and specialty pharmacists – RNs, LPNs, NPs, PAs – Physicians and dentists – Medical, dental, and radiology technicians and assistants – Dietitians – Health and wellness coaches – Health and fitness trainers – Case managers and referral coordinators [photo TK]

Health System Pharmacies – Reflecting Growing Access and Addressing Service Needs 100+ locations • Planned expansion to 196 locations in 2013 • Premier locations include: – – Teaching hospitals Hospital networks Children’s hospitals Community hospitals • Staffed by Pharm. Ds and pharmacists • Locations include HIV/AIDS Centers of Excellence

Comprehensive Portfolio of Health Systems Management Solutions Walgreens integrates outpatient pharmacy into the healthcare continuum On-site outpatient pharmacies • Improves access to specialty and limited-distribution therapies Employee access to 30 d/90 d Rx • Improves MPR and patient adherence Well. Transitions. TM Specialty Pharmacy • Reduce penalty for avoidable readmission Home Infusion Services • Access to 340 B solutions • Coordinates post-discharge care through the nation’s largest network of retail pharmacies Community-based Take Care Clinics®

Rate of Medication Drop Off – Nearly 1 in 3 Patients Don’t Fill 100% 50% - 70% 48% - 60% 25% - 30% 15% - 20% Prescriptions Brought to Pharmacy Picked up Are Taken Properly Are Refilled Source: IMS

Well. Transitions Strategic Vision • Assisting health systems with avoiding readmission penalties • Bridging the care gap • Redefining role of the pharmacist • Intervention based care model • Collaboration efforts with interdisciplinary healthcare teams • Increasing access and extending care through 8, 000 community locations

Well. Transitions – Three Phased Approach Hospital Treatment Post-discharge Care • Interventions 1 -4 • Patient identified, enrolled in program • Generate medication history • Fill, alignment and reconciliation of discharge medications • Bedside delivery of medication and patient consultation • Interventions 5 -7 • Pharmacist education follow up initiated 48 -72 hours after discharge • Pharmacist clinical therapy review approximately 10 days post-discharge • Community integration provided by pharmacist at day 25 post-discharge Aligned with health system core measures Focused on reducing preventable readmissions Coordinated effort to drive HCAHPS scores Coordinated care with community providers Integrates data points – EMR, ADT, alerts Outcomes Reporting • Final Intervention • Comprehensive reporting capabilities • Advanced data analytics • Measure clinical outcomes and economic effectiveness • Real-time access through secure web portal

Pharmacist Driven Program to Increase Medication Adherence • Range of pharmacist-mediated interventions utilizing evidence based guidelines • Ability to monitor adherence through comprehensive analytics • One-on-one pharmacy/patient medication education and review sessions • Accurate patient profile and comprehensive medication history • Complement to other intervention initiatives and activities

Bridging the Gap, Coordinating Care Health System • • Offered as part of patient care services If necessary, identifies and targets high risk patients Integrated into daily workflow Provides feedback and is an advocate of benefits Walgreens • Medication history provided at admission, medication review, alignment • Ease of transition, follows patient in own environment, reviews medication instructions • Documents any change in therapy, alerts health system and community provider to any issues Loopback Analytics • Determines patient eligibility based on pre-select health criteria • Collects and maintains data points (medical and pharmacy) • Pushes tasks and communications based on role/responsibility and severity • Integrates data points – EMR, ADT, alerts Community Health Providers • Integrated into care continuum with two-way communications • Educated on health status of patient • Enhances patient/provider relationship with full view of medication history

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De. Kalb Medical Center – Early Version of Well. Transitions Program initiated January 2011 with De. Kalb Medical (Main) and is based on their process of improving core measure goals • Patients in the care transition program had a lower 30 -day readmissions rate (5. 6 percent compared to 10. 6 percent) than patients in the same hospital in the year prior to program initiation • Unadjusted readmission rates Duncan, I. De. Kalb’s Comprehensive Medication Compliance Approach Cuts Readmissions. Healthcare Financial Management Association (HFMA) Leadership e-Bulletin: February 2013 Issue. http: //www. hfma. org/

Patient Satisfaction Results from De. Kalb Medical Patient Satisfaction (HCAHPS Scores) was a significant driver of the decision to implement Well. Transitions/bedside delivery. There was a dramatic improvement in HCAHPS “Communication about medicines” domain scores 1 26% relative increase in HCAHPS domain score 63% at 65 th percentile 50% at first percentile ACHIEVED IN THE FIRST 90 DAYS From the first percentile to the 65 th percentile. 1. Stemphiak M. , Bedside Delivery-an Easier Pill to Swallow. HHN (p 2 -3), August 2012