Healthcare Intelligence Network
Accountable Care Organizations
Best Sellers
Behavioral Healthcare
Bundled Payment
Care Coordination
Care Transitions
Case Management
Chronic Care Management
Coming Soon
Community Health
Cultural Diversity
Data Analytics
Diabetes Management
Disease Management
Dual Eligibles
Emergency Medicine
Health Literacy
Health Risk Assessments
Health Risk Stratification
Healthcare Reform
Healthcare Trends
HIN Benchmark Reports
HIN Case Studies
Home Health
Home Visits
Hospital Readmissions
Infection Control
Information Technology
Long-Term Care
Managed Care
Medical Home
Medical Neighborhood
Medical Practice
Medical Records
Medication Adherence
Nurse Management
Palliative Care
Patient Engagement
Patient Experience
Patient Registry
Pay for Performance
Physician Practice Transformation
Physician Organizations
Physician Quality Reporting Initiative
Population Health Management
Post-Acute Care
Predictive Modeling
Quality Improvement
Remote Patient Monitoring
Revenue Cycle Management
Social Health Determinants
Training DVDs
Value-Based Reimbursement
What's New
Subscribe to the Free
'Healthcare Business Weekly Update' e-Newsletter and receive the latest trends, news and analysis in healthcare.

Click here to view this week's issue
Home > Webinars
A Leading Care Transitions Model: Addressing Social Health Determinants Through Targeted Home Visits, a 45-minute webinar, on March 23rd, now available for replay
A Leading Care Transitions Model: Addressing Social Health Determinants Through Targeted Home Visits, a 45-minute webinar, on March 23rd, now available for replay
Be the first to review this item
Your Price:
Choose Format and Quantity
Webinar Format On Demand version
MP3 Download
Training DVD and transcript, Available 4/13
CD-ROM and transcript, Available 4/13
12-Month Membership to HIN Webinar Series
Add to Wish List
If you are already a Healthcare Intelligence Network webinar member, then this webinar is FREE for you.

Not a member, but want to attend all of our webinars for one year for just $1, $800 savings! Simply sign up for the HIN Webinar Membership Series, and you'll get access to this must-attend webinar AND all of our programs for the next 12 months. Click here to sign up for this limited time offer today.

Sun Health, an Arizona non-profit organization, launched its Sun Health Care Transitions program in November 2011. Modeled after the Coleman Care Transitions Intervention® and adapted to meet the needs of its community, the program has been credited with keeping readmission rates well below the national average.

Sun Health's program was part of the Center for Medicare and Medicaid Services' National Demonstration Program, Community-Based Care Transitions Program, which ended in January. Not only did Sun Health lead the CMS demonstration project with the lowest readmission rates, Sun Health also widened the gap between their expected 30-day readmission rate (56 percent lower than expected) and their expected 90-day readmission rate (60 percent less than expected).

During A Leading Care Transitions Model: Addressing Social Health Determinants Through Targeted Home Visits, a March 23, 2017 webinar, now available for replay, Jennifer Drago, FACHE, executive vice president, population health, Sun Health, shares the key features of the care transitions program, along with the critical, unique elements that lead to its success.

You will learn:

  • How Sun Health adapted the Coleman Care Transitions Intervention® to meet the needs of its community;
  • The key roles of the care transition care team, which include a registered nurse, a licensed practical nurse and a social worker, and how and when they interact with the patient;
  • How addressing social health determinants and applying a chronic disease focus within the program improved results;
  • How Sun Health links to existing services in its community for aging in place to help address barriers to care plan adherence; and
  • Sun Health's approach to sustaining the program now that the CMS Community-Based Care Transitions Program demonstration project has ended.

Have questions on our webinar formats? Visit our webinar FAQ.

You can attend this program right in your office and enjoy significant saving—no travel time or hassle; no hotel expenses. It's so convenient! Invite your staff members to gather around a conference table to listen to the conference.


Presidents & CEOs, medical directors, quality improvement executives, physician executives, performance improvement professionals, case and care management executives, and strategic planning directors and consultants.


Jennifer Drago

Jennifer DragoJennifer Drago, FACHE, MHSA, MBA, is the Executive Vice President of Population Health for Sun Health, where her role is to identify community health needs and to develop and operate services to meet these needs.

Drago has launched seven new community health programs in the past five years, including an innovative chronic disease/wellness program, a nationally-recognized transitions of care program, and a continuing care at home program that is the first of its kind in Arizona. She also helped to form a new community nonprofit to focus on senior transportation.

Drago has 23 years of healthcare experience including work in planning, operations and policy. She is a Fellow of the American College of Healthcare Executives. She earned a bachelor's degree in finance, an MBA and a master's in health services administration from Arizona State University.

Publication Date: March 23, 2017
Number of Pages: 45-minute webinar
Frequently Bought Together
Post-Discharge Home Visits: 5 Pillars to Reduce Readmissions and Engage High-Risk Patients
Post-Discharge Home Visits: 5 Pillars to Reduce Readmissions and Engage High-Risk Patients
Your Price: $89.00
2017 Healthcare Benchmarks: Home Visits
2017 Healthcare Benchmarks: Home Visits
Your Price: $125.00
Browse Similar Items
What's New
Value-Based Reimbursement
Care Transitions
Home Visits
Social Health Determinants

2019 Healthcare Benchmarks: Social Determinants of Health
2019 Healthcare Benchmarks: Care Coordination
Proactive Care Management in a Top-Performing ACO: Closing Quality and Care Gaps in High-Risk, High-Utilization Populations
Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success
The Science of Successful Care Transition Management: Leveraging Home Visits to Improve Readmissions and ROI

Copyright Healthcare Intelligence Network. All Rights Reserved. eCommerce Software by 3dcart.