Care Transitions Learning Community

This program is no longer active.


The Affordable Care Act included health system changes that provided incentives for reduced re-hospitalizations and improved care transitions. To help service providers prepare for these changes, we created a Care Transitions Learning Community in January 2011.

Building on the success of our Improving Care Transitions initiative, the Care Transitions Learning Community gave health care leaders the opportunity to participate in educational events each month, with the focus on specific components of the Affordable Care Act, opportunities released by the Center for Medicare and Medicaid Innovation and best practice models for reducing re-hospitalizations and/or improving care transitions.

To provide ongoing support for care transitions coaches, we also introduced a Care Transitions Learning Community for Transitions Coaches in October 2011.


We successfully hosted more than 30 webinars from 2011 to 2013 on topics like “The Integration of Family Caregivers and Coaching,” “The Importance of Considering Cultural Diversity During Transitions of Care,” and “Using Teach Back to Improve Communication with Patients,” among others.