TABLE 2.

Features of Medicare Coordinated Care Demonstration Programs That Cut Hospital Admissions of High-Risk Patients

Telephone calls to patients and frequent in-person meetings Occasionally meeting in person with health care providers Acting as a communications hub for providers Delivering evidence-based health care education to patients Providing medication management Providing comprehensive transitional care after hospitalizations

Source. From Nelson, L. (2012, January). Lessons from Medicare’sdemonstration projects on disease management, care coordination, and value-based payment. Washington, DC: Congressional Budget Office.