Health of the Aging – Care Example

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"Health of the Aging"  is an engrossing example of a paper on care. What is the CCTP Initiative? The Abbreviation CCTP stands for Community-based Care Transition Programs. This was an initiative that was created under section 3026 of the Affordable Care Act.   (CMS. GOV, 205) Identify and discuss the overall goals of the CCTP. The Community based Care Transitions Program has various goals that it seeks to achieve. Being a transitions program, it has the goal of ensuring that its beneficiaries in the country experience a good transition from being inpatients in hospitals to other different settings besides the hospital.

The initiative also has a goal to ensure that their patients in those other settings are given high-quality medical care so that they are not readmitted in the hospital settings again. Thirdly, the program seeks to achieve high standards of medical care and not only to dispense high quality but also to continuously and constantly improve the quality of the medical care that they provide at all times. Fourthly, the initiative also seeks to continuously test models for improving patient care while transitioning from hospitals to other settings.

This plays a crucial role in ensuring that the quality of medical care services offered is continuously increasing and at the same time reducing the risks which may come with dispensing a medical activity or new medical enhancement drugs or equipment without first testing the materials for their effectiveness. The program also has a role to reduce the amount spent on expediting the activities. This is done through continuously evaluating the most cost-effective methods of transitioning thus documenting quantifiable savings to the program.   What data was used to justify this initiative This initiative is based on the fact that close to one patient in every five patients who have been discharged from the hospitals will most likely be readmitted in 30 days.

Again, one patient in every three patients who have been discharged from hospitals will be readmitted in 90 days. According to the Medicare Advisory Commission on Payments, there is an estimated expense of approximately 15 billion US dollars every year to cater for readmissions. Though the hospitals had been in the frontline to prevent readmissions, they were not able to effectively handle all the factors that impacted on readmissions.

They were not able also to identify the opportunities downstream to reduce readmissions. Armed with this data, the CCTP program was launched to identify these opportunities downstream to bring down readmission rates which were and is critical to solving the problem.   (Bladezj, 2015) How will the participating organizations be evaluated on their effectiveness? Most of the organizations which are involved in the CCTP program are CBOs or Community Based Organizations. The partnering CBOs are evaluated on the basis of transition care they offer across the continuum of medical care.

The evaluation of performance will also be conducted based on other factors such as mortality rates of the patients; this is done through monitoring 90 days and 180 days readmission rates. Finally, the CBOs are also assigned CMS officers who serve as a liaison between the program and staff of the evaluation contractor. (Centre for Medicare and Medicaid Services, 2015)


Bladezj, L. (2015, February 20). Community-Based Care Transitions Programs: An Initiative to Reduce Hospitalizations. Retrieved from Launchmed Website:

Centre for medicare and Medicaid Services. (2015). Community-Based Care Transitions Programme: Facysheet. New York: CMS.

CMS. GOV. (205, February 21). Community-based Care Transitions Program. Retrieved from Centre for Medicare and Medicaid Services:

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