Transitional Care Support (TRC/TCM)
Close the gap between hospital discharge and timely follow-up—with structured outreach, medication reconciliation support, and audit-ready documentation.
Medicosmos delivers the execution layer behind Transitions of Care—supporting TRC and TCM workflows with time-bound follow-up, documentation discipline, and medication reconciliation support.
We help primary care organizations manage post-discharge episodes reliably, reduce operational burden, and maintain audit-ready evidence—without rebuilding your internal team.
If you already know the TRC guidelines, we help you run them consistently under real-world constraints.
Governance model: You own workflow definitions, policies, and KPIs. We execute the work inside your systems under agreed steps and report weekly on performance and exceptions.
Designed for Medicare Advantage / Value-Based Primary Care transitions-of-care execution.
Volume reflects cumulative workflow execution delivered through long-running programs.
Admission & Discharge Tracking
Structured intake and monitoring so discharge events don’t get missed and cases don’t fall through the cracks.
Patient Engagement & documentation
Time-bound outreach support and documented contact outcomes to keep transitions moving and evidence defensible.
Medication Reconciliation Support
Identification of medication discrepancies post-discharge and coordination support to reduce avoidable risk.
Follow-Up Scheduling & Escalation Protocols
Ensuring follow-up readiness within required timelines, including escalation support when clinic capacity is constrained.
Want to see what an execution-first TRC workflow looks like?
Request a short readiness call or get our TRC Execution Scorecard Template.
