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

  • Data show lower admissions, ED use with population health programs

    CMS Deputy Administrator and Chief Medical Officer Dr. Patrick Conway announced that the Comprehensive Primary Care and Multi-payer Advanced Primary Care Practice initiatives lead to a 2% reduction in hospital admissions and a 3% decrease in emergency department visits. Savings have totaled $4.2 million. Health IT Analytics (1/26)

  • Study: 4.6% of elderly hospitalized after ED discharge

    A study from the University of California, Los Angeles, found 4.6% of Medicare beneficiaries discharged from a hospital emergency department were admitted to a hospital within seven days. The study in the Journal of the American Geriatrics Society linked an increased risk of admissions to diagnoses such as heart failure and end-stage renal disease, age, skilled nursing facility use and leaving the ED against medical advice. (1/23)

  • CMS posts online ratings for dialysis centers

    A five-star rating system has been included in the CMS' Dialysis Facility Compare website with the most recent update of quality measure data. The star ratings are scheduled to be updated annually starting in October. The ratings were added in response to a report by the Government Accountability Office, but Kidney Care Partners and Dialysis Patient Citizens have said the ratings need more work and don't reflect the actual performance of dialysis centers. Health Data Management (1/23)

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