CMS Announces Three Florida Community-Based Care Transitions Programs

The Centers for Medicare & Medicaid Services announced 17 sites that have been selected to participate in the Community-based Care Transitions Program (CCTP). Together with the first 30 program participants, the CCTP now includes 200 acute care hospitals partnering with community-based organizations across 47 sites to provide care transitions services for an estimated 185,800 Medicare beneficiaries annually residing in 21 states.

The CCTP is a five-year program created by the Patient Protection & Affordable Care Act. Participants sign two-year program agreements with CMS, with the option to renew each year for the remainder of the program based on their success. The goal of the program is to reduce readmissions for high-risk Medicare beneficiaries by improving transitions of beneficiaries from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high risk beneficiaries and to document measurable savings to the Medicare program. As of this announcement, CMS continues to accept applications and approve participants on a rolling basis as long as funds remain available.

Three programs in Florida have been selected to participate in the CCTP:

Osceola-St. Cloud Community-based Care Transitions Coalition is a partnership of the Senior Resource Alliance, the AAA and ADRC for the Orlando region, Osceola Regional Medical Center, St. Cloud Regional Medical Center and several skilled nursing facilities.

Greater Miami Coalition to Prevent Unnecessary Rehospitalizations is led by the Miami-Dade County Alliance for Aging and is partnering with seven hospitals and multiple home health and social service providers. Hospital partners include Baptist Hospital of Miami, Doctors Hospital, Jackson Memorial Hospital, Larkin Community Hospital, Mount Sanai Medical Center, South Miami Hospital and University of Miami Hospital.

Elder Options will serve low-income, rural and medically underserved populations across 55 zip codes and 13 counties in North Central Florida. The Mid-Florida Area Agency on Aging will work with two acute care hospitals (Shands Hospital at the University of Florida and the North Florida Regional Medical Center) as well as local providers including home health agencies, skilled nursing facilities and the University of Florida’s College of Nursing.

Is your agency participating in one of these new care transitions programs? Click here to let HCAF know and your agency will receive pertinent information about the CCTP!

For more information, visit Communities that wish to apply to the program are encouraged to contact FMQAI‘s point-of-contact:

Peggy Loesch
Care Transitions Quality Specialist
(813) 865-3438
Email address

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