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Care Coordination & Referrals

Expert articles and analysis related to care coordination & referrals.

199 articlesLast 30 Days

AI Summary — Last 30 Days

CMS is pushing care coordination from a “nice-to-have” capability into a payment-model requirement, with mandatory joint-replacement expansion through TEAM creating stronger incentives for hospitals to manage referrals, discharge planning, home health relationships, and post-acute spend across episodes of care. At the same time, NCQA’s move toward person-centered outcome measures for SNPs and ECDS-based Transitions of Care reporting signals that referral management and care-plan execution will increasingly be judged through digital, patient-centered quality infrastructure—not just claims lag or process documentation. For ACOs, hospitals, home health agencies, and payers, the strategic pressure is converging around building preferred post-acute networks, specialist alignment, and interoperable care-transition workflows before expanded accountability models such as TEAM and digital quality requirements like HEDIS ECDS Transitions of Care become operational constraints.

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