Case Study
Wellth reduces AdventHealth DeLand’s 30-day hospital readmission rates by over 50%
57
%
Reduction to hospital
readmission rates
in enrolled cohort
8
%
30-day readmission
rate in Wellth cohort
91
%
Average daily
adherence through
the Wellth app
AdventHealth DeLand is an acute-care hospital based in Central Florida. Like many acute-care hospitals, DeLand experiences hundreds of hospital readmissions annually that are linked to poor care plan adherence. To drive down these 30-day readmissions, DeLand partnered with Wellth on a medication adherence rewards program for post-discharge patients.
Background
AdventHealth DeLand is an acute care hospital that experiences over 8,000 discharges annually. In 2019, DeLand engaged Wellth to help reduce their Medicare Hospital Readmission Reduction Program (HRRP) penalty, which was due to excessive 30-day hospital readmissions. The Hospital Readmission Reduction Program was launched by the Centers for Medicare and Medicaid Services (CMS) in 2012 with a goal of improving the quality of healthcare provided by hospitals. Medicare payments made by CMS to hospitals are adjusted annually based on their 30-day readmission rate for the following six conditions:
  • Acute Myocardial Infarction (AMI)
  • Congestive Heart Failure (CHF)
  • Chronic Obstructive Pulmonary Disorder (COPD)
  • Pneumonia (PN)
  • Coronary Artery Bypass Graft Surgery (CABG)
  • Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty (THA/TKA)
Hospitals can lose up to 3% of their Medicare payments annually due to the HRRP penalty; in Performance Year 2017, AdventHealth DeLand had an annual Medicare HRRP penalty of approximately $183,000 and AdventHealth network had an aggregate annual HRRP penalty of over $8 million. For more information on HRRP visit CMS.gov.
Start Date
February 2019
Location
DeLand, Florida
Disease States
Acute Myocardial Infarction, Pneumonia, Chronic Obstructive Pulmonary Disorder, Congestive Heart Failure
Insurance Coverage
Medicare
“The goals of our partnership with Wellth are fewer readmissions and much healthier patients.”
— Joey Pineda
AdventHealth DeLand
Case Manager
Impact of Medication Adherence on 30-Day Readmission Rate
Numerous studies have found statistically significant correlation between low post-discharge medication adherence and 30-day readmission rates for many of the conditions measured by CMS HRRP. Furthermore, 30% of readmissions occur within the first 7 days post-discharge, making it extremely important for adherence interventions to begin immediately after patients leave the hospital.
Adherence Support for Each Patient from the Moment they are Discharged
The Wellth + DeLand program was launched in 2019 in response to DeLand’s rising HRRP penalties. The program was specifically offered to Medicare patients discharged from DeLand Hospital with a diagnosis of Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disorder (COPD), or Pneumonia (PN). Prior to Wellth, DeLand had an average 30-day readmission rate of approximately 19% for these four conditions.

Each eligible DeLand patient was notified of the Wellth program prior to discharge by the DeLand care transitions team. Interested patients were immediately connected with a Wellth Member Specialist representative to be enrolled into the Wellth Rewards smartphone app with the help of the DeLand care transitions team. The Wellth Rewards program offered a $50 rewards card for verifying daily adherence to prescribed medications over 30 days. Enrolled members received a daily notification to check in a photo of their prescribed medications in order to keep their $50 reward. For each day they missed a check-in, $2 was deducted from the $50 reward balance. This leverages the concept of Loss Aversion from behavioral economics to drive better adherence outcomes. They also had access to a live Wellth Member Specialist support team throughout the duration of the 30-day program.

DeLand patients who heard about the Wellth Program were motivated by the $50 reward card and therefore quick to sign up for the app. Over the course of 30 days, they became highly engaged with Wellth's contextual reminders and enjoyable platform, leading to the extremely strong outcomes we have observed to-date.
“Awesome app and program. Wellth really helped me keep track of my meds and my care plan team was right there if I ever needed them!”
— AdventHealth / Wellth member
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References