Effect of Person-Centered Telehealth Service Implementation on 30-Day Readmissions and Hospital Reimbursement: A Prospective Comparative Study

OBJECTIVE: To evaluate the association between implementation of a personalized, postdischarge telehealth support program and 30-day hospital readmission among patients hospitalized with stroke. METHODS: This observational pre-post implementation study was conducted within an acute care hospital system and included adult patients (≥18 years) admitted with ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Following discharge, eligible patients were offered enrollment in a person-centered telehealth support program. The primary outcome was all-cause 30-day readmission. Multivariable regression models were used to adjust for baseline clinical characteristics. RESULTS: Among 405 patients, 258 were admitted before telehealth implementation, 31 were enrolled in the telehealth program after implementation, and 116 were postimplementation nonenrollees. Thirty-day readmission occurred in 23 of 258 patients (8.9%) before implementation, in 0 of 31 telehealth enrollees (0%), and in 3 of 116 nonenrollees (2.6%). After adjustment for clinical covariates, postimplementation patients demonstrated a lower estimated risk of 30-day readmission compared with preimplementation patients, with the lowest risk observed among telehealth enrollees. Based on a 6.3% absolute reduction in readmissions and published cost estimates, telehealth implementation corresponded to an annual savings of approximately $112,000-$124,000 in avoided uncompensated care for uninsured patients and $545,000-$602,000 in reduced exposure to denied claims for insured patients per 1,000 strokes. Anticoagulant use was associated with a higher estimated probability of readmission. CONCLUSION: Implementation of a person-centered postdischarge telehealth service was associated with substantially lower 30-day readmissions among patients hospitalized with stroke and may provide meaningful economic benefits by reducing costly readmissions and financial burden on hospitals.