Transitions of Care

Transitions of Care (TOC) is an important topic for the transformation of health care. It is the movement of a patient from one care setting to another involving a set of proactive actions. Many patients leave the hospital, rehabilitation facility, or long-term care setting often in a vulnerable state with little understanding of what comes next.

As part of Highmark's Population Health University, we held a panel discussion in order to highlight why effective transitions in care are important and discuss collaborative efforts to support care coordination. We also discussed how improvements to patient care have a positive effect on the patient, physician experience, and readmission rates.

The following panel discussion was produced in collaboration with The American Journal of Managed Care^® (AJMC^®).

• Mike Samczak – Director, Value-Based Clinical Performance & Development, Population Health & Strategic Integration, Highmark Health
• Kelsey Brenner – Population Health Pharmacy, Highmark Health
• Amanda Mihalko – Director Social Determinants of Health, Allegheny Health Network
• Holly D’Amico – Vice President, Utilization Management, Highmark Inc.
• Amy Foster – Director Clinical Services High Costs, Utilization Management, Highmark Inc.
• Melinda Mervosh – Director, Case & Disease Management National Markets, Highmark Inc.

• Julie Hobson - Population Health Performance Specialist, Highmark Health

Part 1: Welcome and Panel Introduction

Part 2: Effective Transitions in Care and How This Has Been Heightened During the Pandemic

Part 3: Examples of Good Handoffs and Coordination With Practices in Our Network

Part 4: How Can Providers Help Patients Maneuver Through the System?

Part 5: How Does Highmark Help Support the Transition of Care Process Within Our Network?

Part 6: Final Thoughts