Abstract: 170 The American Journal of Cardiology (www.ajconline.org) time frame analysis showed a significant drop in hospitalization rates just after PC encounters, and continued to decrease over time (Panel A). The annual trends for 90-day all-cause hospitalization rates before PC encounters showed a significant reduction over time (59.7% in 2010 to 53.3% in 2018, p <0.001), but hospitalization rates after PC remained stable over the study period (Panel B). In this observational nationwide analysis of over 25,000 acute on chronic HF admissions, PC encounters were associated with a significant reduction in all-cause, HF-specific, and non-HF 90-day hospitalization rates. This reduction was noted immediately after discharge from the index admission with a PC encounter. Hospitalization rates before PC utilization decreased over the study period perhaps due to the early recognition of value of PC among these sick patients. This study is limited by the nature of this administrative database which carries a risk of mis- or under-coding. Additionally, we could not identify patients who died after hospital discharge. Some of the reduction in readmission may be due to this factor. However, it is unlikely that death would account for the entire decrease in admission rates after a hospital PC consultation, since not all patients seen by PC physicians are appropriate for hospice or accept a palliative approach to care, and the previously reported post-HF discharge 30-day mortality rate »7% (1). Moreover, the philosophical change of care to a palliative approach encourages a decrease in low-value health care utilization such as repeat hospital admissions at the end of life. In summary, we found that patients who received a PC encounter during a hospitalization had a reduction in subsequent readmission rates. Further studies should assess the competing risk of death in this population. Disclosure: The authors have nothing to disclose, and no relationship with industry. Funding: Self-funded Ahmed Elkaryoni, MDa,* Brett W. Sperry, MDb Anna Royce, MDc Kevin Walsh, MDd Elizabeth Bruno, MDd Subir Shah, DOa,d Amir Darki, MD MSca,d Islam Y. Elgendy, MDe a Division of Cardiovascular Disease, Loyola University Medical Center, Loyola Stritch School of Medicine, Maywood, Illinois b Division of Cardiovascular Disease, Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri c Department of Internal Medicine, University of Oklahoma, Oklahoma d Department of Internal Medicine, Loyola University Medical Center, Loyola Stritch School of Medicine, Maywood, Illinois e Divison of Cardiology, Weill Cornell MedicineQatar, Doha, Qatar 27 January 2021 1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics2020 update: a report from the American Heart Association. Circulation 2020;141:e139–e596. 2. Diop MS, Bowen GS, Jiang L, Wu WC, Cornell PY, Gozalo P, Rudolph JL...