Reducing 30-day Readmissions Through Efficient Transitional Care Management

A leading Midwestern clinically integrated network (CIN) has more than 4,000 health practitioners and 200,000 patients in value-based care arrangements. The CIN previously struggled to determine which patients were at high risk for readmittance and to efficiently coordinate care. The organization deployed the Innovaccer Health Cloud to deliver high-quality post-discharge care to patients, improve the efficiency of transitional care management (TCM) protocols, reduce 30-day readmissions, and generate savings.

Key Takeaways

• Implement TCM protocols on 48% of all discharges
• Reduce its 30-day readmittance rate from 13.4% to 9.8% from January 2020 to November 2020
• Realize $341,000 in savings