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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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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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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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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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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