Care Transitions

Care Transitions Links

Department of Health and Human Services - Transitional Care Management Services

Scientific Articles

Dowling R. (2016, June 10). How to bill and code transitional care management the right way. Article.

Jones CD, Burke RE. Annals for Hospitalists Inpatient Notes - Getting Past the “Black Box”—Opportunities for Hospitalists to Improve Postacute Care Transitions. Ann Intern Med. 2018;168:HO2–HO3. doi: 10.7326/M18-0940. Article. 

Radhakrishnan K, Jones TL, Weems D, Knight TW, Rice WH. Seamless Transitions: Achieving Patient Safety Through Communication and Collaboration. J Patient Saf. 2018 Mar;14(1):e3-e5. Abstract.

Werner NE, Tong M, Borkenhagen A, Holden RJ. Performance-Shaping Factors Affecting Older Adults' Hospital-to-Home Transition Success: A Systems Approach. Gerontologist. 2019 Mar 14;59(2):303-314. Abstract.