Hospital to Home

The Hospital to Home (H2H) Initiative is a resource for hospitals and cardiovascular care providers committed to improving transitions from hospital to "home" and reduce their risk of federal penalties associated with high readmission rates.


Start now with an ACC (CardioSource) login, or register for access today.



Self-contained improvement projects that include a goal statement, success metrics, a tool kit, an assessment, and 3 webinars (evidence, tools, lessons learned) that provide participants with recommended strategies and tools to achieve small, attainable goals in their organization.

  • See You in 7

    The goal of the H2H SY7 Challenge is for all patients discharged with a diagnosis of HF/AMI to have a follow-up appointment scheduled/cardiac rehab referral made within 7 days of hospital discharge.

  • Mind Your Meds

    The goal of the H2H MM Challenge is for clinicians and patients discharged with a diagnosis of HF/MI to work together and ensure optimal medication management.

  • Signs and Symptoms

    The goal of the H2H S&S Challenge is to activate patients to recognize early warning signs and have a plan to address them.

Getting Started

Kick-start H2H at your hospital by utilizing the ”Getting Started Checklist.”

Get Started


Interact with others on a listserv who share best practices and lessons learned.

Find out more

News And Research

  • CMS official links lower hospital, ED use to support for primary care

    A 2% decrease in hospital admissions and emergency department visits can be linked to increased CMS support for primary care, the agency's chief medical officer, Patrick Conway, told the National Quality Forum's annual conference. He highlighted several population health and coordinated care projects, initiated by hospitals and physician practices, that have reduced costs and improved quality of care. HealthLeaders Media (3/25)

  • AHA calls for changes in readmission penalty policy

    An American Hospital Association report calls for the government to change the Affordable Care Act's Hospital Readmissions Reduction Program, stating "not all readmissions can or should be prevented." The AHA said the program creates frustration and confusion and its penalty formula for high readmissions fails to consider socioeconomic factors that affect rates. Healthcare Finance News (3/25)

  • Coordinated care with diabetes self-management boosts outcomes in PCMHs

    Integration of diabetes self-management education and support within coordinated care settings was associated with reduced HbA1C levels among patients in patient-centered medical homes, U.S. researchers reported in The Diabetes Educator. Healio (free registration) (3/24)

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