Posts in Transition to Adult Care
Recommendations for Value-Based Transition Payment for Pediatric and Adult Health Care Systems: A Leadership Roundtable Report

Margaret McManus, Patience White, and Annie Schmidt. The National Alliance to Advance Adolescent Health, September 2018.

To address long-standing gaps in payment for transition to adult care, this report presents new value-based payment (VBP) recommendations for pediatric to adult health care transition. Funded by the Lucile Packard Foundation for Children’s Health, this report is intended to guide commercial and Medicaid payers, health plans, employers, and pediatric and adult systems of care in implementing and evaluating VBP options for transitional care. The report is a result of an expert panel of payers, plans, professional organizations, and advocacy groups convened by The National Alliance to Advance Adolescent Health and 65 key informant interviews with major stakeholder groups. See more →

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Health Care Transition in State Title V Programs: A Review of 2018 Block Grant Applications and Recommendations for 2020

by Samhita Ilango, Margaret McManus, and Daniel Beck. Got Transition, September 2018.

This report summarizes the health care transition (HCT) efforts of 32 states that elected to prioritize HCT as one of their five selected priority NPMs (in addition to the District of Columbia and Puerto Rico) as reported in state Title V agencies’ 2018 Block Grant Applications. The report highlights examples of HCT innovations pertaining to 1) education and leadership development with families and youth; 2) outreach and education efforts with health care professionals; 3) communication and social media efforts to update and disseminate state-of-the-art HCT information; 4) systems development efforts with sister state agencies; and 5) practice improvement initiatives. The report also offers a detailed set of recommendations for the 2020 State Title V Action Plan, due in 2019, which will lay the groundwork for the following five years. See more →

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The National Alliance to Advance Adolescent Health Receives Five-Year Federal Award to Direct the National Resource Center on Health Care Transition

The National Alliance to Advance Adolescent Health received a 5-year award from the federal Maternal and Child Health Bureau (MCHB) within the U.S. Department of Health and Human Services, Health Resources and Services Administration to continue its operation of Got Transition, the national resource center on health care transition (HCT). The goal of this new award will be to spread the adoption of evidence-informed HCT improvements as part of a comprehensive system of services for youth and young adults with and without special health care needs, focusing special attention on low-income and medically underserved populations.  See more →

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Incorporating Health Care Transition Services into Preventive Care for Adolescents and Young Adults: A Toolkit for Clinicians

By Patience White, Annie Schmidt, Margaret McManus, and Charles Irwin, Jr. Got Transition, June 2018.

A Preventive Care and Transition Toolkit developed by Got Transition in collaboration with University of California, San Francisco’s (UCSF) Adolescent and Young Adult Health National Resource Center. It provides suggested questions and anticipatory guidance for clinicians to introduce health care transition during preventive visits with early adolescents (ages 11-14), middle adolescents (ages 15-17), late adolescents (ages 18-21), and young adults (ages 22-25), consistent with the AAP/AAFP/ACP Clinical Report on Health Care Transition. See more (ALSO En Español)

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

February 2, 2018

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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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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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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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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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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Pediatric Perspectives and Practices on Transitioning Adolescents with Special Needs to Adult Health Care 

by Margaret McManus, Harriette Fox, Karen O'Connor, Thomas Chapman, Jessie MacKinnon, October 2008.
Based on a 2008 national AAP survey of practicing pediatricians, this fact sheet examines pediatricians' perspectives on the appropriate age to begin planning for transition and their practices regarding the provision of transition support services to adolescents with special needs. It also identifies the economic and non-economic barriers that pediatric practices face in providing transition services and presents options for improving training, financing, adult provider availability, and adolescent and parent education. See more

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