Medica Administrative Manual > Health Management and Quality Improvement > Care Management > Transitions of Care Program

Transitions of Care Program

The purpose of the Transitions of Care (TOC) Program is to assist members who are at risk of a readmission with a safe transition between settings of care to improve health outcomes and reduce unplanned readmissions.

Case management services are focused on the members’ first 30 days following discharge from an inpatient or post-acute setting. Members are identified through a Daily Admission Report that utilizes an algorithm to identify the members who would most benefit from the additional support. Medica nurses conduct telephonic intervention to verify that the discharge plan is successfully meeting the member’s needs. 

If barriers to discharge are identified, for adult, pediatric or Neonatal Intensive Care Unit (NICU) members, case management will work with the hospital discharge planning teams to assist with supporting and planning for home or facility discharge. For more information about the TOC Program, please call Medica Case Management at 1(866) 905-7430 or email us.

REV 1/2024