Medicare Transition of Care Program

The Medicare Transition of Care Program is designed to support patients moving from hospital or skilled nursing facilities back home. It ensures healthcare providers coordinate the patient’s ongoing care, reduce hospital readmissions, and prevent complications. Through this program, healthcare teams review treatments, medications, and follow-up plans within a specific period after discharge. This coordinated approach helps patients understand their care plan, manage medications properly, and address any health concerns promptly, ultimately promoting smoother recoveries and improved health outcomes.