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.


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

News And Research

  • MSSP results show ACO model can work

    Accountable care organizations participating in the Medicare Shared Savings Program in its first four years served older, sicker populations than typical health care providers do but still managed to improve quality while reducing postacute care expenditures. The results suggest that the ACO model "might work in other settings and populations and could shift to more advanced risk and payment models (eg, population-based prospective payment)," the study authors write. The American Journal of Managed Care online (2/13) Learn More

  • AAP, POSNA add pediatric orthopedic tests to Choosing Wisely list

    Five orthopedic procedures or tests that may not be needed in assessing children with hip, foot and other musculoskeletal conditions have been added by the American Academy of Pediatrics and the Pediatric Orthopaedic Society of North America to the AAP's Choosing Wisely list, which aims to curb additional testing in order to reduce false-positive findings. "There should always be a conversation between physician and patient on what procedures and tests are really necessary," said Dr. Brian Shaw of the AAP Section on Orthopaedics, who added that "sometimes less is more" when it comes to testing. Medscape (free registration) (2/13) Learn More

  • Family care program helps hospital cut readmissions

    Intermountain Healthcare's Partners in Healing program, which includes family members in providing patient care, helped reduce 30-day readmissions by 65% at Intermountain Medical Center, according to a study in the journal Chest. A survey found 92% of patients said it enhanced their transition from hospital to home. Healthcare Finance News (2/13) Learn More