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Care Management

Transitions of Care (TRC)

Operated by a national health plan on the 1health platform.

Automate the high-friction period when a patient moves from the hospital to primary care, ensuring follow-up occurs and quality gaps are closed.

Monthly Volume

40,000-50,000 patients

Star Rating Lift

1-2 to 4-5 Stars

The Objective

Automate the high-friction period when a patient moves from the hospital to primary care, ensuring follow-up occurs and quality gaps are closed.

Built on 1health

This application is composed from 1health protocols, services, and modules. The mapping below shows how each app capability is enabled by platform pieces.

Service

ADT Ingestion

Real-time processing of Admission, Discharge, and Transfer feeds from hospitals.

Protocol

Shared Ledger

Longitudinal, auditor-approved record where discharge data is committed for payer review. Cross-organizational by design.

Service

TCM Billing

Auto-documentation for Transitional Care Management (TCM) codes.

Module

Notifications

Multi-channel alerts to providers via DSM, fax, and secure messaging.

App Capabilities

Real-time discharge alerts

ServiceProtocol

Follow-up appointment tracking

ProtocolModule

TCM code documentation

ServiceProtocol

Provider notification

ModuleService

1health Platform Pieces

ServiceADT Ingestion
ProtocolShared Ledger
ServiceTCM Billing
ModuleNotifications
Capability to Platform Piece Mapping
App CapabilityEnabled By
Real-time discharge alertsADT Ingestion (service), Shared Ledger (protocol)
Follow-up appointment trackingShared Ledger (protocol), Notifications (module)
TCM code documentationTCM Billing (service), Shared Ledger (protocol)
Provider notificationNotifications (module), ADT Ingestion (service)

Outcomes

4-5 Stars

Medicare Advantage rating lift within 6 months

300,000+

Critical care gaps closed annually

$200-$300+

New PCP revenue per discharge via TCM

3.3x

100-person team scaled from 90K to 300K annual units

Build Without vs. With 1health

Build Without 1health

  • Estimated Timeline: 18-24 months for initial build
  • Requires building custom ADT parsers for hundreds of hospital feeds
  • Achieving NCQA/SOC2/HIPAA compliance for data storage
  • Creating 1:1 integrations with dozens of EHRs

The 1health Advantage

  • Launch in weeks using MCP APIs for ADT data
  • Leverage 1health's existing Auditor-Approved data model
  • Pre-built hospital feed integrations
  • Compliance infrastructure included

Ready to build on 1health?

See how 1health can accelerate your healthcare workflow automation.

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