In an effort to improve coordination across the continuum of care, Louisiana Health Care Review (LHCR), the Medicare QIO for Louisiana, has set an unprecedented standard for change. LHCR is one of 14 QIOs performing the sub-national Care Transitions Theme, which aims to improve health care processes at and after hospital discharge to reduce unnecessary rehospitalization among Medicare beneficiaries. Within six months of the program’s inception, LHCR lowered the readmission rate in the Baton Rouge area from about 19 percent to about 5 percent, far exceeding its original 2 percent goal.