JAMA

22 Jan Transitional Care Management Expands, Delivered Mostly In Primary Care Offices

MedicalResearch.com Interview with: [caption id="attachment_52904" align="alignleft" width="106"] Dr. Marcotte[/caption] Leah Marcotte, MD Clinical Assistant Professor, Medicine University of Washington   MedicalResearch.com: What is the background for this study? Response: In the last 7 years, Medicare has implemented payment reforms to encourage primary care and other ambulatory providers for dedicated care coordination activities. One such reform, Transitional Care Management (TCM) billing codes, was introduced in 2013 and emphasized coordination during care transitions from hospital to home – a particularly vulnerable period in which patients may be at risk for adverse outcomes. TCM services include patient contact (e.g., phone call) within two business days of discharge, a visit (e.g., office or home-based) within 14 days of discharge with at least moderate complexity medical decision making, and medication reconciliation. TCM services may be delivered after inpatient hospitalization, observation stay, skilled nursing facility admission or acute rehab admission. There have been few studies that have looked at early data in Transitional Care Management, and none that have described national use of and payment for these codes over an extended period of time. We analyzed a national Medicare dataset looking at 100% of submitted and paid TCM claims from 2013-2018.