10  In order to balance the model, avoidable utilization must be reduced by improving care and care coordination  30- Day Readmissions/Rehospitalizations (includes ER)  Preventable Admissions (based on AHRQ Prevention Quality Indicators)  Nursing home residents—Reduce conditions leading to admissions and readmissions  Maryland Hospital Acquired Conditions (potentially preventable complications)  Improved care coordination: particular focus on high needs/frequent users, involvement of social services earlier on Near Term Success Factor: Reduce Avoidable Utilization By Improving Care
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