Recognizing that high numbers of avoidable hospital readmissions are indicative of a poorly functioning health care system, the Board in 2008 approved an investment in the State Action on Avoidable Rehospitalizations (STAAR) initiative to develop and test a model of statewide system collaboration to redesign the care transition process for patients leaving the hospital. To date, 64 hospitals in Massachusetts, Michigan, and Washington have participated in the effort, receiving technical assistance from experts working with frontline care transition teams. STAAR also supports coalitions of providers, purchasers, and state officials charged with addressing systemic barriers and identifying solutions. In the next phase, a second cohort of 50 hospitals in Massachusetts and Michigan will engage in the collaborative. By 2012, three to five hospitals in each state are expected to be ready to serve as national role models for improving transitional care, and one-fifth of hospitals will have lowered 30-day readmissions by 20 percent to 30 percent within a pilot population.