Activity ID



April 20, 2020

Format Type


CME Credit



CME Provider

American Medical Association


Increasing administrative responsibilities due to regulatory pressures and evolving payment and care delivery models reduce the amount of time physicians spend delivering direct patient care. Much of the cost burden in health care is created by patients with high utilization of emergency and inpatient services. These super-utilizing patients typically have multiple chronic conditions, polypharmacy and high social complexity (e.g., mental health issues, low health literacy, limited income, lack of transportation and low social support). One in five patients with chronic health problems also suffer from preventable drug therapy problems, including medication errors and nonadherence. Complex patients are particularly at risk for serious drug therapy problems and during care transitions from hospital to home. Managing super-utilizing patients and preventing drug therapy problems often falls on primary care providers once patients are discharged from the hospital. These patients and the practices that serve them are particularly likely to benefit from following the SafeMed care transitions team model. The costs of care transitions from the hospital to other care settings are one of the most expensive aspects of the health care system; these transitions cost anywhere between $12 billion to $44 billion per year. Additionally, due to reimbursement changes under the Affordable Care Act, providers are now focusing more intensively on improving care transitions. Therefore, this module will provide much needed education on this topic so that providers will keep up with the new scrutiny on care transitions.

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NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

Educational Objectives

Identify complex patients who are candidates for the program
Assemble and train your SafeMed team
Develop and implement your care transitions plan for your practice
Evaluate and refine the care transitions plan over time


Transitions of Care


Interpersonal & Communication Skills, Practice-based Learning & Improvement, Professionalism, Systems-based Practice

CME Credit Type

AMA PRA Category 1 Credit

MIPS Approved

This activity qualifies for the CMS Merit-based Incentive Payment System (MIPS), where you can earn a performance-based payment adjustment to your Medicare payment

Physician Well-being activity

Efficiencies in Medical Practice

Practice Setting

Inpatient, Outpatient, Rural, Urban

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