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"The TRC Multiplier Effect: How Operational Excellence in Transitions of Care Drives HEDIS and CMS Star Ratings"

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Most health plans are blind to their members' most critical moments. By the time they learn about hospitalizations and discharges, HEDIS® Transitions of Care measure criteria windows have already closed—leaving care gaps they can't address when it matters most. The cost: preventable readmissions, missed interventions, and members who fall through the cracks during their most vulnerable transitions.

Here's what leading plans understand: Operational excellence in transitions of care creates a multiplier effect. Real-time visibility into acute and post-acute movements—combined with automated workflows that activate providers within critical windows—doesn't just improve one metric. It drives simultaneous performance gains across provider communication, medication reconciliation and follow-up coordination which can lead to readmission reduction and improved member experience.

Plans that master real-time transitions of care can:

• Intervene within a timely manner before care gaps become crises
• Prevent costly readmissions
• Unlock performance improvements in provider communication, timely follow-up and medication reconciliation

Ready to stop chasing closed windows? Join NCQA and PointClickCare to discuss how the Transitions of Care measure can transform quality performance.

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