Posts tagged Research
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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Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010–2016: Implications for Future Health Reforms

by Donna L. Spencer, Margaret McManus, Kathleen Thiede Call, Joanna Turner, Christopher Harwood, Patience White, and Giovann Alarcon, March 2018

This article from the Journal of Adolescent Health examines changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. The report shows significant improvements in coverage among children, adolescents, and young adults since 2010.  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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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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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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State EPSDT Policies for Adolescent Preventive Care

by Harriette B. Fox, Katherine K. Rogers, and Margaret A. McManus, September 2011.
This fact sheet presents findings from an analysis of state policy documents that establish guidelines for providers delivering EPSDT preventive services to adolescents. It examines state Medicaid policies including the EPSDT periodicity schedule; comprehensive health history and developmental assessments; physical examinations, laboratory tests, and immunizations; health education; and referrals. Particular emphasis is given to the early identification of problems related to nutritional health, mental health, sexual behavior, substance use, and violence and injury potential and to health education for key topics under Bright Futures. Also examined are state policies regarding adolescents’ private time with providers. See more

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Future Directions for the Office of Adolescent Health

by Harriette B. Fox and Bruce P. Frohnen, February 2011.
This report presents the views of clinical and policy experts on how the HHS Office of Adolescent Health can best carry out its legislative charge to improve adolescent health outcomes through increased coordination. The report, based on more than 30 interviews, provides recommendations for interagency coordination around program design and evaluation, research, and health care provider training activities as well as for the coordination of efforts aimed specifically at preventing mental and behavioral health disorders and improving systems of care. Also included are perspectives on the need for a national plan to improve adolescent health. See more

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Strengthening Preventive Care to Better Address Multiple Health Risks Among Adolescents

Presentations by Harriette B. Fox, Margaret A. McManus, Susan K. Maloney, Angela Diaz, and Anne Morris, November 2010.

This report summarizes the presentations at the Adolescent Preventive Services Institute at the American College of Preventive Medicine 2010 Annual Meeting. It reports on the prevalence and co-occurrence of teen risk behaviors, the underutilization of clinical preventive services for adolescents, and barriers to the delivery of preventive care. The report also presents evidence-informed strategies for improving clinical and community prevention and includes a description of the Mount Sinai Adolescent Health Center as an innovative primary care model. See more →

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Concern for Our Teens: Opinion Leaders Speak Out on Adolescent Health

by Bruce P. Frohnen, Margaret A. McManus, Stephanie J. Limb, and Celia R. Straus, July 2010. 
This report examines the perspectives of opinion leaders in business, academia, and the military on adolescents' health and access to care. It also addresses the leaders' opinions on the role of their community in health education and public and private policy actions needed to improve adolescent health. Information was obtained through interviews with leaders from a cross section of large and small firms in both manufacturing and service sectors; public, private, and community colleges; and several branches of the military. See more →

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