April 6, 2023
According to the American Journal of Managed Care, the ineffective transferring of a patient from one care setting to another often leads to confusion about treatment plans, missed follow-up appointments, patient dissatisfaction, medication non-adherence and, most importantly, unnecessary readmissions.
The Transitions of Care (TRC) HEDIS® measure focuses on the percentage of members who had an acute or non-acute inpatient discharge during the measurement year and had each of the following:
- Notification of inpatient admission
- Receipt of discharge information
- Patient engagement after inpatient discharge
- Medication reconciliation post-discharge
Documentation of all four components must be in any outpatient record, as well as accessible by the PCP or ongoing care provider.
We encourage providers to enroll your practice in an admission, discharge, and transfer alert system (ADT) to ensure timely receipt of information and to create provider alerts and tracking for follow-up. Primary care providers should include non-acute (surgical) admissions in post-discharge outreach and medication reconciliation even if post-surgical treatment is being performed through a specialist, to coordinate and support whole-person health.
The TRC tip sheet has information about this measure, including exclusions, best practices, and documentation requirements.
For more information, email ProviderClinicalConsulting@Premera.com.
Healthcare Effectiveness Data Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Source: American Journal of Managed Care