Comments to the Social Security Administration on Strategies to Improve Adult Outcomes for Youth Receiving Social Security Income (SSI)

Comments to the Social Security Administration regarding its Request for Information on Strategies to Improve Adult Outcomes for Youth Receiving Social Security Income (SSI), focusing particular attention to the distinct needs of transition-age youth and young adults, ages 14 to 25. See more

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Comments to CMS on Pediatric Alternative Payment Model Concepts

April 7, 2017

Comments to the Centers for Medicare and Medicaid Services regarding their Pediatric Alternative Payment Model Concepts, which urge CMS to consider the population of Medicaid and CHIP-insured adolescents and young adults with behavioral health conditions, intellectual/developmental disabilities, and/or complex medical conditions who are between the ages of 16 and 25 and moving from pediatric to adult service systems. See more

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Letter to the Presidential Transition Team on Child and Adolescent Mental Health Priorities

December 19, 2016

A letter to President-elect Trump, Vice President-elect Pence, and the Presidential Transition Team that set forth “Child and Adolescent Mental Health Principles,” a list of six concrete opportunities to improve and enhance mental health services for children devised by a coalition of organizations representing a diverse array of perspectives. See more

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Aligning National Title V Performance Measures on Transition, Medical Home, Preventive Care, and Insurance: Suggested Strategies for States

by Margaret McManus, Daniel Beck, and Patience White. Got Transition 2016.

This report offers strategies for state Title V agencies that have selected transition as one of their to help them link performance improvements and innovations for transition with medical home, adolescent well care, well care for women, and adequate health insurance. See more

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State Title V Health Care Transition Performance Objectives and Strategies: Current Snapshot and Suggestions

by Margaret McManus, Daniel Beck, and Patience White. Got Transition, February 2016.

This report analyzes FY 2016 State Title V Action Plans of the 32 states that have selected transition as one of their priorities over the next five years. The report offers specific suggestions for 1) aligning transition objectives with the new national transition measure in the upcoming National Survey of Children's Health and the Six Core Elements of Health Care Transition, and 2) selecting measurable strategies related to expanding availability of adult providers, evaluating health care transition implementation, and expanding quality improvement and educational efforts using the Six Core Elements. See more

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Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project

by Margaret McManus, Patience White, Robin Pirtle, Catina Hancock, Michael Ablan, Raquel Corona-Parra. Journal of Pediatric Nursing. 2015;30:700-713.

This article describes the results of and lessons learned from incorporating the Six Core Elements of Health Care Transition into a DC Medicaid managed care plan that serves SSI-eligible youth and young adults. It summarizes the extent of transition improvements within the plan and receipt of recommended transition core elements among a pilot group of young adult enrollees needing to transfer from pediatric to adult health care. See more

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Comments to CMS on the Application of Mental Health Parity Requirements to Medicaid and CHIP

June 8, 2015

Comments to the Centers for Medicare and Medicaid Services regarding Medicaid and Children’s Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organization, the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans. See more  

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Pediatric to Adult Transition: A Quality Improvement Model for Primary Care

by Margaret McManus, Patience White, April Barbour, Billie Downing, Kirsten Hawkins, Nathalie Quion, Lisa Tuchman, W. Carl Cooley, and Jeanne McAllister. Journal of Adolescent Health. 2014;56:73-78.

This article examines the results of implementing the Six Core Elements of Health Care Transition in five large pediatric and adult academic primary care sites in the District of Columbia, as part of a two-year learning collaborative. Using the Health Care Transition Index, the study compares improvements in specific indicators of transition performance in pediatric and adult practices. It also discusses quality improvement lessons learned. See more

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Measuring the “Triple Aim” in Transition Care: A Systematic Review

by Megan Prior, Margaret McManus, Patience White, and Laurie Davidson. Pediatrics. 2014;134:e1648-e1661.
This article identifies published measures used to evaluate transition within the “Triple Aim” framework of experience of care, population health, and costs. Within this framework, the article describes the specific measures used in the 33 studies that met inclusion criteria. It also includes a critical discussion of transition measurement gaps and suggestions for developing a cores set of transition measures. See more

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The Promise and Potential of Adolescent Engagement in Health

by Margaret A. McManus. Journal of Adolescent Health. 2014:314.

This editorial discusses a new youth engagement tool developed by Sebastian et al. in the Journal of Adolescent Health and recommends incorporating transition readiness assessment in future measures of adolescent engagement consistent with Got Transition’s “Six Core Elements of Health Care Transition.” It also addresses the need to consider the continuum of adolescent engagement pertaining to direct care as well as to involvement of youth as staff, peer educators, advisory group members, and other leadership positions. See more

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Lack of Comparability Between CHIP and ACA Qualified Health Plans

by Margaret A. McManus and Harriette B. Fox, July 2014. 

This fact sheet provide a detailed examination of comparability between separate CHIP programs and child-only qualified health plans in Colorado, Georgia, Oregon, Texas, and West Virginia for children with family incomes between 134% to 300% FPL. It examines cost-sharing requirements, including deductibles, copayments and coinsurance, and out-of-pocket limits, and benefit coverage and treatment limitations in 28 benefit categories. Implications for CHIP reauthorization are also discussed. See more

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Many Low Income Older Adolescents Likely to Remain Uninsured in 2014

by Harriette B. Fox, Margaret A. McManus, and Annalia G. Michelman, October 2013.

This fact sheet identifies the states in which adolescents ages 19 and 20 living at or below the poverty level are likely to remain without health insurance protection in January 2014, despite the passage of the Affordable Care Act. It examines several avenues to state Medicaid coverage: optional Medicaid eligibility for “Ribicoff Children” up to age 21, Section 1115 demonstration waivers covering childless adults, and the ACA’s optional Medicaid expansion for uninsured individuals ages 19 through 64. It also describes the obstacles these older adolescents confront in securing private health insurance coverage through employment and in exchanges. See more

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A Research Agenda for Adolescent-Centered Primary Care in the United States

by Harriette B. Fox, Margaret A. McManus, Charles E. Irwin Jr, Kelly J. Kelleher, and Ken Peake. Journal of Adolescent Health. 2013:307-310. 

This commentary presents a set of prioritized research recommendations on adolescent-centered primary care developed by experts participating in The National Alliance to Advance Adolescent Health's invitational conference in 2012. The recommendations pertain to increasing adolescent and parent engagement and self-care management, improvement preventive care and identifying conditions early, and integrating physical, behavioral, and reproductive health services. The commentary also addresses federal and private foundation funding priorities related to the adolescent research agenda. See more →

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Current Status of Transition Preparation Among Youth With Special Needs in the United States

by Margaret A. McManus, Lauren R. Pollack, W. Carl Cooley, Jeanne W. McAllister, Debra Lotstein, Bonnie Strickland, and Marie Y. Mann. Pediatrics. 2013;131:1090-1097.
This article provides an analysis of US transition performance from pediatric to adult health care based on the 2009-2010 National Survey of Children with Special Health Care Needs. It examines the association of population, condition, and health care characteristics with successful transition preparation. It also identifies adolescent populations least likely to receive needed transition support and offers delivery system and payment suggestions for improvement. See more

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Private Coverage Under California's Affordable Care Act: Benefit and Cost-Sharing Requirements Affecting Children and Adolescents With Special Health Care Needs

by Margaret McManus and Harriette Fox, May 2013.
This issue brief examines the extent to which California’s essential health benefits benchmark plan meets the needs of children and adolescents, including those with special needs. It also examines the cost-sharing requirements that will be used by health insurance plans sold in California’s Health Insurance Exchange. It identifies potential issues of concern in the benchmark’s essential health benefits, with special attention to families’ out-of-pocket cost liabilities within all five levels of coverage, including subsidized coverage. See more

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Comments to HHS on Proposed Rule on Medicaid, CHIP, and Exchanges

February 13, 2013

Comments from The National Alliance to the Centers for Medicare and Medicaid Services on the Proposed Rule on Medicaid, Children’s Health Insurance Programs, and Exchanges, issued on January 22, 2013, to implement provisions of the Affordable Care Act (ACA) and the Children’s Health Insurance Program Reauthorization Act (CHIPRA). See more

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A Primary Care Quality Improvement Approach to Health Care Transition

by Patience H. White, Margaret A. McManus, Jeanne W. McAllister, and W. Carl Cooley. Pediatric Annals. 2012;41:e1-e7.
This article describes a quality improvement approach for implementing health care transition supports in pediatric and adult primary care practice settings, which is based on the 2011 AAP/ACP/AAFP's Clinical Report on Health Care Transition and the Six Core Elements of Health Care Transition. It includes detailed sample tools, strategies, and lessons learned from primary care practices in the District of Columbia that have implemented the Six Core Elements. See more

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Medical Home Innovations: Where Do Adolescents Fit?

by Ian Walker, Margaret McManus, and Harriette Fox, December 2011.
This report provides a summary of the activities underway in 12 innovative medical home programs and discusses how the health needs of adolescents are being addressed. Findings are based on interviews with leaders in public, private, and multi-stakeholder programs. The report examines each of the seven principles central to the medical home model: personal provider, physician-directed practice, whole person orientation, care coordination, quality and safety, enhanced access, and payment for excellence. It describes the progress that has been made in changing primary care practices and plans underway for future improvements. See more

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