CMS Health Care Innovation Award - Transition Home Plus Program

Program Location: 
Providence, RI
Payer Type: 

Women and Infants Hospital of Rhode Island received an award to improve services for approximately 2400 families in Rhode Island who have pre-term or high-risk full term babies with a Neonatal Intensive Care Unit (NICU) admission of 5 or more days. The Partnering with Parents intervention has hired, trained and deployed Early-Moderate Preterm, Late Preterm, and high-risk full term family care teams to offer education and support to parents during the transition from the NICU to home, and monitor infants’ growth and development. The program also supports primary care providers who help provide care for this at-risk population and has partnered with home nursing agencies throughout the state to coordinate infants’ care post discharge. The results are expected to be reduced emergency room visits, fewer hospital readmissions, and decreased neonatal morbidity. This approach is expected to lower costs while improving health and health care for pre-term and high-risk full term babies in Rhode Island with estimated savings of approximately $3.7 million.

Last updated April 2014
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