Managed Healthcare Executive November 3, 2025
Transitions of Care (TRC), Medication Reconciliation Post-Discharge (MRP), and Plan All-Cause Readmissions (PCR) are among the measures that have a major effect the Star Rating of health plans.
If you’re still using claims data to manage care, you’re already too late. When critical information about discharges, medication changes, or ED visits arrives weeks after a critical health inflection point, care managers lose the opportunity to act when it matters most. You’re managing complications instead of preventing them.
The greatest opportunity
Transitions of care are where coordination most frequently breaks down — and where health plans have the greatest opportunity to influence outcomes across multiple quality measures.
Effective postdischarge coordination creates a compounding impact: better medication adherence, closed chronic care gaps,...
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