Transition Coach Program Implementation Associated with Thirty-Day Readmission Rates in a Community Hospital Setting

Background: With implementation of Medicare policies affecting reimbursement for readmissions, there has been increased emphasis on quality of care during transition from hospital to home. Several models for improved care, such as utilization of transition coaches, have developed to address barriers to quality healthcare that are prevalent in this care transition. 

Objective: To study the effect of implementation of a transition coach program on thirty-day readmission rates in a community setting serving a predominantly low-income patient population. 

Design: Retrospective cohort study. 30-day readmission rates of control group were compared to group receiving transition coach services.