Transition to Home: Rapid Scaling of a Multistate Readmission Prevention Program for Advanced Alternative Payment Model Participants

NEJM June 15, 2022
Marc Rothman, MD, Theresa Bretz, NP-C, MSN, CPA, Angela Farinella, FNP-BC, Justin Rock, MBA, John Kliewer, CHES, CSPO, Lisa Brian, and Brenda Tsai Meu Chong, CBAP, POPM, RAP, CSPO

Summary

Reducing unnecessary readmissions to acute care hospitals is a key lever of success in many advanced alternative payment models. Despite the proven effectiveness of evidence-based transitional care, hospitals and health systems often have difficulty scaling and sustaining postdischarge transitional care programs. As the United States’ largest convener of Medicare’s Bundled Payments for Care Innovation Advanced (BPCI-A) program, Signify Health implemented and rapidly scaled a virtual-first, evidence-based, interdisciplinary transitional care program now serving patients in 15 states. In the first 12 months since...

Today's Sponsors

Today's Sponsor