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