This case study highlights FirstHealth of the Carolinas' Hospital to Home Transitions of Care pilot program. Essential elements of this initiative include revamped, evidence-based COPD patient education materials, spirometry training for primary care physicians; the use of discharge order sets; pulmonary rehabilitation; and the implementation a modified set of internal processes and training to execute the program successfully. Both results and lessons learned are included. This resource will be most helpful to healthcare providers and health systems administrators interested in implementing care improvement and readmissions reduction programs at their organizations.