Reducing Readmissions by Leveraging a Comprehensive Care Transitions Approach

A Medicare Payment Advisory Commission report to Congress highlighted the financial enormity of the readmission crisis in health care. In anticipation of potential readmission penalties, the organization developed a multidisciplinary improvement initiative to reduce avoidable readmissions and improve transitions in care. Following a comprehensive review of patient management challenges and several years' readmission experience, several care coordination strategies were implemented.