During a 42-Month follow-up of Accountable Care Organization (ACO)-Enrolled Patients, Admissions with Subsequent TCM Services (n =101) Had a 5% Readmission Rate, Compared with an 11.9% Readmissions Rate for Admissions That Did Not Receive Subsequent Transitional Care Management (TCM) Services (n = 2103), Representing a 58% Decrease in the Readmission Rate (P = 0.03).
| No TCM Services | TCM Services | Relative Decrease in Readmission Rates | |||
|---|---|---|---|---|---|
| Division | Readmissions / Admission (n) | Readmission Rate | Readmissions / Admission (n) | Readmission Rate | |
| A | 41/317 | 12.9% | 0/4 | 0.0% | 100% |
| B | 43/445 | 9.7% | 1/28 | 3.6% | 63% |
| C | 95/739 | 12.9% | 3/43 | 7.0% | 46% |
| D | 71/602 | 11.8% | 1/26 | 3.8% | 67% |
| System-wide | 250/2103 | 11.9% | 5/101 | 5.0% | 58% |