Care Transitions Learning and Action Network - Integrating Care for Populations & Communities

The Care Transitions LAN will focus on improving the quality of care for Medicare beneficiaries as they transition between providers. Participants will form relationships with community organizations and health care providers and coordinate activities to ensure community-wide adoption of best practices.

Who Should Attend?

  • AAA/ARCH
  • hospitals
  • skilled nursing facilities
  • home health care agencies
  • nursing homes
  • hospice and palliative care providers
  • non-medical home organizations
  • patient advocacy groups
  • community-based organizations
  • physician offices
  • healthcare associations
  • ACO/ACC

Goals

The goal of the care transitions LAN is to improve the quality of care for Medicare beneficiaries as they transition between care settings by promoting community-wide adoption of evidence-based best practices. LAN activities will support state and national goals:

Colorado

  • 7% reduction in 30-day hospital readmissions, 5% reduction in hospital admissions, and
    2% reduction in costs in communities tackling care transitions together by July 2014
  • 2% relative improvement rate decrease in 30-day readmissions and admissions statewide by July 2014

National

Interested in Participating?

Click Here to Sign Our Participation Agreement, Data Sharing Agreement and Media Release

Resources    

Care Transitions Toolkit

Archived Biweekly Care Transitions Roundup Newsletters from CFMC

Free Webinar Learning Sessions

Session Recordings

Contact Information

For more information about the CFMC Integrating Care for Populations and Communities program, contact Lacey McFall at lmcfall@cfmc.org or 303-784-5746.

Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS Policy.