The coordination of medical and long-term services and supports (LTSS) plays a crucial part in care transitions. When there’s no one to provide oversight across every stage of an individual’s health care journey, a weak point in the chain occurs, and something breaks.

Gaps in care can happen when a patient leaves one healthcare environment and enters another. For example, when an elderly patient with mobility issues goes to a hospital for surgery, is discharged to an assisted living facility for recovery, then returns home, this puts them in three different environments due to that one surgery.

Health plans are the one constant through a member’s journey, accompanying them through every transition. And the best part is that care managers’ tasks and priorities already align with most care transition models.

Download the free eBrief Why Care Managers Are Perfectly Positioned to Improve Care Transitions to learn more about how care managers and coaches can take advantage of this opportunity to lower costs for health plans, lower readmission rates, and create better health outcomes.