Background: Hospital readmissions are common, costly and largely preventable. Objectives: To evaluate the impact of a pharmacy-led medication discharge and post discharge counseling program on 30 day readmission rates for HF (heart failure) and AMI (acute myocardial infarction). Methods: Three month prospective, quality improvement, pilot study with HF and AMI patients who received pre-discharge and post-discharge medication counseling from December 2013 to February 2014 whose 30 day readmission rates were compared to readmission rates from the previous fiscal year.Results: Fifty-one patients were included in the study. Primary endpoint of 30-day readmission rates showed a 33.9% decrease for AMI and a 50.1% decrease for HF in readmission rates compared to the previous fiscal year, with a potential annual savings of $458,800. The study also identified 25.5% of patients having at least one medication error that was identified through medication reconciliation. Conclusions: Pharmacy provided medication reconciliation and medication discharge counseling reduced readmission rates as well as decreased medication errors. There is also a potential for significant health cost savings.