Transitions of Care HEDIS Star measure focuses on medication management, care coordination for Medicare Advantage patients

The ineffective transferring of a patient from one care setting, such as a hospital, nursing facility, primary care provider, long-term care, home health or specialist care, to another often leads to problems, according to the American Journal of Managed Care.** It can result in confusion about treatment plans, missed follow-up appointments, patient dissatisfaction, medication nonadherence and, most importantly, unnecessary readmissions.

The Transitions of Care (TRC) HEDIS^® Star measure focuses on the percentage of members who had an acute or nonacute inpatient discharge during the measurement year and who 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 the outpatient record and accessible by the primary care provider or ongoing care provider.

If you haven’t already done so, we encourage you to establish an office practice that explains to patients why it’s crucial that they inform your office about their hospital admissions and discharges. Let them know this can improve care coordination, maintain their safety and improve their health.

Read this tip sheet to learn more about this measure, including exclusions, best practices and documentation requirements.

HEDIS^®, which stands for Healthcare Effectiveness Data Information Set, is a registered trademark of the National Committee for Quality Assurance, or NCQA.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.