Transitional Care Management


TCM is a focused program for members transitioning from acute or post-acute facilities back to the community.

From the moment of discharge until 30 days from index facility discharge, a RN Case Manager facilitates the patient’s care in collaboration with the healthcare team to address short term barriers to a safe and effective post-discharge recovery during a critical window of care.

Benefits of TCM include stabilizing and optimizing the member’s health and recovery to help reduce avoidable readmissions.

Transitional care management (TCM) is designed to bridge the gap and ensure that primary care providers follow up with their patients in a structured, reimbursable manner after discharge from a hospital, skilled nursing facility, inpatient rehab facility, or other healthcare setting.

Patient engagement, turnkey service, no hidden fees.

Providers benefit from a broad range of available Medicare fee-for-service programs. Carepointe provides a platform to improve healthcare quality while maximizing Medicare reimbursement revenue. Our service is turnkey and includes no overhead costs, or upfront charges so physicians can implement our programs with no financial risk.