Abstract 10521: Frequency and Impact of Virtual Follow-Up Visits After Heart Failure Hospitalizations: Insights from Michigan

Abstract

Introduction: Outpatient follow-up after heart failure hospitalization has been shown to reduce readmission and emergency department (ED) visits. Hypothesis: We sought to evaluate the use of virtual follow up-care heart failure hospitalizations in a commercially insured population. Methods: We queried the Michigan Value Collaborative multipayer claims database for heart failure hospitalizations in patients discharged to home or home health between 7/20-11/20. We identified follow-up visits as outpatient office visits within 30 days of discharge, and categorized each patient as having an in-person only, virtual-only (GT or 95 modifier code), both virtual and in-person, and no follow-up visit. Multivariable logistic and linear regression was used to evaluate the association between follow-up visit type and 30-day readmissions, ED visits, and price-standardized episode spending. Results: A total of 2415 patients were discharged alive after a heart failure hospitalization: 94 (3.9%) patients had a virtual-only follow-up visit, 258 (10.7%) had both in-person and virtual visits, 1551 (64.2%) had in-person only follow-up visits, and 512 (21.2%) had no follow-up within 30 days of discharge. Adjusted analyses revealed that patients receiving both virtual and in-person visits had similar rates of 30-day readmissions (aOR=0.73, 95% CI: 0.42, 1.27), ED visits (aOR=0.52, 0.26, 1.07), and episode spending (adjusted difference= -$1508, 95% CI: -$3835, $821; Table ). However, patients receiving only virtual visits or no follow-up had significantly higher 30-day readmissions (aOR=2.31, 95% CI: 1.21, 4.42) and episode spending (adjusted difference= $1974, 95% CI: $206, $3742) compared to in-person visits. Conclusions: Virtual follow-up visits occurred in nearly 15% of heart failure patients, but had mixed results on patient outcomes. More evidence is needed to support the role of virtual-only follow-up visits after heart failure hospitalizations.