A randomized control study of the Care Transitions Intervention found that intervention patients had lower hospital readmission rates than control patients at each time interval studies (30 days, 90 days and 180 days).  Intervention patients also had significantly lower hospital costs at 90 days and 180 days.

The primary costs of the model are the salary and benefits for the coach, mileage reimbursement for the coach, cell phone and pager and photocopying of the personal health records and other supplies. In the studied intervention, the annual cost for the program was $74,310. 

Extrapolating both the potential costs and cost savings from the study period to a full year yields projected net annual cost savings of $295,594.

Organizations that have adopted the model have reported that Transition Coaches detect medication discrepancies in over 40% of patients.   Patients who work with Transition Coaches are significantly more likely to achieve 30-day personal health goals.

Anecdotally, nurses serving as Transition Coaches find the new role fulfilling and feel that empowering patients is a very important but often neglected aspect of being a nurse.  Most health care professional training and employment is oriented around doing things for patients.  In contrast, Transition Coaches encourage patients to do as much as they can for themselves.  Once coached, patients can continue to use these skills into the future.  The ability to positively influence a patient’s care today and also into the future is particularly gratifying.

As noted above, patients who work with Transition Coaches are significantly more likely to achieve 30-day personal health goals.  In addition, patient refusal of the program is very rare (less than five percent).