PointClickCare Unveils Transitions of Care Solution to Help Medicare Advantage Plans Boost CMS Star Ratings

New solution delivers real-time, EHR-agnostic admission and discharge insights to payer-provider networks to enhance care coordination, reduce readmissions, and improve quality performance

TORONTO, March 11, 2025 /PRNewswire/ -- PointClickCare, a leading healthcare technology platform enabling meaningful care collaboration and real-time patient insights, today announced that it has launched its Transitions of Care (TRC) solution at the RISE National Conference. This new technology-driven solution is designed to help Medicare Advantage plans obtain, deliver, and act on time-sensitive admission and discharge information to ensure scalable and repeatable TRC Star measure performance, ultimately improving post-discharge coordination and intervention velocity.

Nearly 20% of Medicare beneficiaries discharged from the hospital were readmitted within 30 days, and 34% were readmitted within 90 days, costing Medicare $17.4 billion annually. This financial burden, coupled with CMS placing greater emphasis on seamless care transitions to improve patient outcomes, demonstrates that it's imperative that Medicare Advantage plans be well-positioned to intervene quickly to prevent avoidable readmissions. PointClickCare's TRC solution is purpose-built to empower Health Plans and their provider networks with a seamless, tech-enabled workflow that automates data access and the delivery of real-time admission notifications and timely discharge information.

"With the heightened focus on CMS Star Ratings, Medicare Advantage plans need smarter, real-time interventions to ensure members receive the right care at the right time," said Brian Drozdowicz, senior vice president & general manager, Acute & Payer markets at PointClickCare. "Our Transitions of Care solution eliminates manual processes and gives plans the visibility and insights they need to proactively manage high-risk members, close critical quality gaps, and ultimately improve both clinical and financial outcomes, further reinforcing our commitment to helping care organizations collaborate more effectively and efficiently."

The TRC solution is designed to optimize post-discharge coordination by automating the real-time access and exchange of admission and discharge data between payers and providers. By leveraging native provider workflows to deliver required information, the TRC solution removes the data access burden to satisfy the "Notification of Admission" and "Receipt of Discharge Information" components of the CMS TRC Star measure within the 48-hour time-bound specifications.

"We've engineered this solution to equip health plans with a standardized and EHR-agnostic data acquisition and delivery mechanism, ensuring seamless use across their provider network," says Whitney Eubanks, vice president of product management, Acute & Payer at PointClickCare. "This capability provides health plans a scalable and repeatable way to stay ahead of the TRC measure cut-point year after year, crucial for achieving operational and financial excellence."

This latest solution builds on the company's proven success in improving patient outcomes through connected care ecosystems. To learn more about how PointClickCare's Transitions of Care solution can help Medicare Advantage plans achieve better clinical and financial outcomes, visit our website here.

About PointClickCare

PointClickCare is a leading healthcare technology platform enabling meaningful care collaboration and real–time patient insights. More than 27,000 long–term and post–acute care providers, 3,600 ambulatory clinics, 2,800 hospitals, 350 risk-bearing providers, 70 state and government agencies, and every major U.S. health plan use PointClickCare for care collaboration and value–based care delivery for millions across North America.

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SOURCE PointClickCare