1. American College of Physicians. Beyond the discharge: principles of effective care transitions between settings. Philadelphia: American College of Physicians; 2023: Position Paper. (Available from American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.)
2. Bindman AB, Blum JD, Kronick R. Medicare’s transitional care payment--a step toward the medical home. N Engl J Med. 2013 Feb 21;368(8):692-4.
3. Centers for Medicare & Medicaid Services. CPC+ care delivery requirements crosswalk. Published December 2019. Accessed: December 14, 2023. https://innovation.cms.gov/files/x/cpcplus-practicecaredlvreqs.pdf
4. National Quality Forum. Emergency department transitions of care: a quality measurement framework. Published August 2017. Accessed: December 14, 2023. https://www.qualityforum.org/Publications/2017/08/Emergency_Department_Transitions_of_Care_-_A_Quality_Measurement_Framework_Final_Report.aspx
5. National Center for Quality Assurance. Follow-up after emergency department visit for people with high-risk multiple chronic conditions. Accessed: December 14, 2023. https://www.ncqa.org/hedis/measures/follow-up-after-emergency-department-visit-for-people-with-high-risk-multiple-chronic-conditions/