Readmissions are a costly medical event that have significant negative consequences on patients’ quality of life and wellbeing. Using Lightbeam’s analytics, Cohort Builder, and automation functionality, a large MSO with ACOs in multiple states launched a transitional care management program to impact readmission rates per one thousand patients. Extending to over 90% of the MSO’s practices, this initiative help staff better manage all patient discharges and prevent readmissions.