logo-cobranded
Hospital Campus (518) 842-1900   •   Memorial Campus (518) 842-3100
 
Hospital Campus (518) 842-1900   •   Memorial Campus (518) 842-3100
 
Hospital Campus (518) 842-1900  •  Memorial Campus (518) 842-3100
 
Hospital Campus (518) 842-1900
Memorial Campus (518) 842-3100
 
Text Size
April 25, 2017
Facebook Twitter Youtube RSS
For more information, please call (518) 774-4596

The federal government has offered an initiative program to help patients covered by Medicare get better faster after they are discharged from the hospital. The Center for Medicare and Medicaid Services has approved three local healthcare organizations. St. Mary’s Healthcare is part of the North Eastern New York Community-based Care Transitions Program (CCTP), a consortium of 16 upstate New York hospitals and healthcare organizations, which serve people in ten counties from the Vermont and Canadian borders south and west to Schenectady and Amsterdam.

The CCTP is an initiative of the Partnership for Patients, a nationwide public-private partnership launched in April 2011 that aims to cut preventable errors in hospitals by 40 percent and reduce preventable hospital readmissions by 20 percent over a three-year period. CCTP’s goals are to reduce hospital readmissions, test sustainable funding streams for care transition services, maintain or improve the quality of care, and document measurable savings to the Medicare program.

Program Benefits

  • Provides the tools to help you better manage your healthcare.
  • Eases your transition from the hospital back to your home, ensuring all your needs are met.
  • Reduces hospital readmissions and emergency department visits.
  • A free service to help you manage your move from the hospital to home.

Care Transitions

  • Specially trained Care Transitions Coaches will visit you in the hospital, at home after discharge, and will follow up with a series of phone calls.  The program typically ends within 30 days of leaving the hospital.

Care Transitions Coach

  • Provide a hospital visit, one home visit, and follow-up phone calls.
  • Review your personal health record (PHR) to improve communication and ensure consistency of care across all providers.
  • Help you identify red flags, to make sure your conditions are not worsening.
  • Educate you on the medications you are taking.
  • Help you schedule and organize your follow-up appointments with your physician.

Confidentiality

  • All information in the Care Transitions Coach program is kept confidential and patient-specific information will never be disclosed without your written consent.

For more information on the Care Transitions Coach program call (518) 774-4596, or use the form below to send us email.

Don't forget to fill in all required fields!

By submitting this form, you accept our privacy policy. View Policy
captcha
Reload

Emergency

  Emergency Department
(518) 841-7237
  Urgent Care
(518) 841-3600
Amsterdam
(518) 773-7710
Gloversville
(518) 770-7818
St. Johnsville
  Mental Health Hotline
(518) 842-9111
  Addiction Crisis Services
(518) 842-9111
Please remember that dialing 911 from your phone will allow trained operators to connect you directly and immediately with assistance that is appropriate to your situation.

Emergency

  Emergency Department
(518) 841-7237
  Urgent Care
(518) 841-3600
Amsterdam
(518) 773-7710
Gloversville
(518) 770-7818
St. Johnsville
  Mental Health Hotline
(518) 842-9111
  Addiction Crisis Services
(518) 842-9111
Please remember that dialing 911 from your phone will allow trained operators to connect you directly and immediately with assistance that is appropriate to your situation.

Ways to Give

  • Donate TodayDonate +

    Affect lives for years to come
  • Attend Our EventsEvents +

    Participate in St Mary's events as a way of giving
  • Plan a GiftGift +

    Make an impact immediately
  • Volunteer NowVolunteer +

    Become a part of our community
  • 1

Ways to Give

  • Donate TodayDonate +

    Affect lives for years to come
  • Attend Our EventsEvents +

    Participate in St Mary's events as a way of giving
  • Plan a GiftGift +

    Make an impact immediately
  • Volunteer NowVolunteer +

    Become a part of our community
  • 1