California Care Transitions—All Providers

The process by which patients move from hospitals to other care settings is increasingly problematic, as hospitals shorten lengths of stay and as care becomes more fragmented. According to the Centers for Medicare & Medicaid Services (CMS), within 30 days of discharge, 17.6 percent of Medicare beneficiaries are rehospitalized, and the Medicare Payment Advisory Commission estimates that up to 76 percent of these readmissions may be preventable.

HSAG of California partners with communities to reduce readmissions following hospitalizations and to yield sustainable and replicable strategies to achieve high-value health care for sick and disabled Medicare beneficiaries. HSAG also provides technical assistance and educates providers, community organizations, and stakeholder groups in the state regarding national care transitions initiatives to reduce readmissions.