As hospitals wrestle with ways to bring down readmission rates, a new Alliance of Community Health Plans report looks at five key steps that improve patients’ odds of being able to go home and stay there. Though the program is still in the early stages, some data suggest that ACHP members with care transition programs are bringing down readmission rates and reducing costs. Still, only a few AHCP plans found “concrete” cost savings from their programs so far.
The report discusses five practices that plans identified as key facilitators of their programs’ success, helping to break down silos of care, promote coordination among providers and engage patients to facilitate effective transitions from hospital to home:
- Using data to tailor care transition programs to patients’ needs
- Anticipating patients’ needs and involving them early in the transition process
- Engaging providers to become program partners
- Leveraging technology to improve care transitions
- Incorporating care transitions into broader quality initiatives
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