Research & Policy Communications

The National Alliance to Advance Adolescent Health/Got Transition has released two new reports and three policy briefs on the significant challenges and inequities that youth and young adults with disabilities face when aging out of Medicaid, CHIP, SSI, and Title V Programs.

This press release describes a new 5-year cooperative agreement from the federal Maternal and Child Health Bureau (MCHB) to the American Academy of Pediatrics (AAP) to form a new national center for the system of services for children and youth with special health care needs.. See more →

This press release describes a new grant award from the Lucile Packard Foundation for Children’s Health (LPFCH) to address the cliff that low-income youth with special health care needs (YSHCN) face as they age into adulthood and lose their child eligibility status in 4 major public programs: Medicaid, Children’s Health Insurance Program (CHIP), Supplemental Security Income (SSI) Program, and Title V Programs for Children with Special Needs. See more →

A toolkit with two tip sheets to assist primary care teams and their young adult patients with ID/DD to plan for disasters and emergencies. The toolkit was developed with an expert advisory group with members from the major primary care professional societies and disability advocates, and it is available in both English and Spanish.

This press release describes a new grant award from the WITH Foundation that will assist primary care providers to care for young adults with intellectual and developmental disabilities during pandemic and emergency situations. See more →

by Annie Schmidt and Margaret McManus, January 2020.

This report summarizes factors influencing adolescent well-care performance in six top-performing state Medicaid programs. State Medicaid officials from the states with the highest adolescent well-care visit performance – RI, CT, TX, NY, NH, and MA – were interviewed to understand the factors contributing to their success. See more →

January 17, 2019

A letter with Public Comments to the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for Healthy People 2030 on the proposed Healthy People 2030 objectives. See more →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

by Harriette B. Fox, Margaret A. McManus, and Shara M. Yurkiewicz, June 2010

This report presents parents’ perspectives on teen health problems and ways to better address them. It reports on what parents understand to be the most pressing health problems teens today face, what their experiences have been in accessing needed services for their adolescent children, what they see as their appropriate role in helping teens to obtain care and stay healthy, and how they think providers can help them. The report also presents parents’ recommendations for an ideal health care site for teens. Information was obtained from seven parent focus groups, including three with Spanish-speaking parents, conducted in Chicago, DC, Los Angeles, and Miami. See more →

by Harriette B. Fox, Susan G. Philliber, Margaret A. McManus, and Shara M. Yurkiewicz, March 2010.

This report presents adolescents’ perspectives on their health care experiences and their ideas about how best to structure a health care delivery system that is responsive to their needs. It addresses several topics, including health issues facing adolescents; experiences with seeking and receiving health care; views on parental involvement; and preferences for the design, services, and staff at an ideal health site. Information was obtained through focus groups and supplemental questionnaires conducted in four cities with over 200 adolescents. See more →

by Harriette B. Fox, Margaret A. McManus, Jonathan D. Klein, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Charles J. Wibbelsman, and Jane E. Wilson. Pediatrics. 2010; 125: 165-172.
This article examines the adequacy of pediatric residency training in adolescent medicine. It addresses several aspects of training, including the extent to which important adolescent medicine topics are covered through formal education and practical application, the types of faculty involved in training, and the opportunities to establish ongoing therapeutic relationships with adolescents. Information for the study was obtained through a 2007 survey of pediatric residency program directors and adolescent medicine faculty. See more →

by Harriette Fox, Margaret McManus, Karen O’Connor, Jonathan Klein, Angela Diaz, and Charles Wibbelsman, September 2009.
Based on a 2008 national survey of practicing pediatricians, this fact sheet examines pediatricians’ interest in adding or expanding preventive, mental health, and reproductive health services for adolescents if payment barriers were removed. It also identifies the specific practice and staffing changes they would have an interest in making, as well as the types of support and training they perceive would be most helpful to them in providing comprehensive primary care to adolescent. See more →

by Harriette B. Fox, Margaret A. McManus, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Jonathan D. Klein, and Jane E. Wilson. Pediatrics. 2008; 121: 1043-1045.
This commentary examines the strengths and weaknesses of four major options for establishing opportunities for training pediatricians in adolescent medicine. The options include extending the length of the mandatory adolescent medicine rotation, introducing more flexibility in residency programs to allow for formalized optional training tracks in adolescent medicine, creating a combined pediatrics/adolescent medicine residency, and increasing the availability of one-year adolescent medicine clinical training programs after completion of categorical training in general pediatrics. Information for this commentary was based on 2007 surveys of adolescent medicine fellowship program directors, pediatric residency program directors, and adolescent medicine faculty in pediatric residency programs. See more →

by Harriette B. Fox, Margaret A. McManus, Jane E. Wilson, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Jonathan D. Klein, and Charles J. Wibbelsman, April 2008.
This special report examines the current state of adolescent medicine fellowship programs. It contains information on the supply and recruitment of fellows; the nature and content of clinical, research, and leadership training; the institutional and financial challenges facing training programs today; and offers recommendations for building the field. Information was obtained primarily from a national survey of adolescent medicine fellowship program directors, along with key informant interviews, and an extensive literature review. See more →

by Marian Sandmaier, Alyssa D. Bell, Harriette B. Fox, and Margaret A. McManus, May 2007.
This report describes a model of comprehensive, interdisciplinary physical, behavioral, and reproductive health care for adolescents operating in three different health care settings — a hospital outpatient department, office practice, and community health center. The strengths and flexibility of the three models are profiled in detail, along with the financing challenges these programs confront. Information was obtained through a site visit and multiple telephone interviews with the programs' providers and administrators. See more →

Nine concrete opportunities to improve and enhance mental health services for children and adolescents, as proposed by a coalition of diverse organizations. See more →

These comments to the Senate Finance Committee from a group of 25 organizations represent a diverse array of perspectives on the worsening crisis in child and adolescent mental health in the United States. See more →

by Samhita Ilango, Annie Schmidt, Margaret McManus, Wun Jung Kim. Journal of the American Academy of Child & Adolescent Psychiatry. 2020;59(4):501-503.

This commentary calls for improving the national projections of the future child and adolescent psychiatry workforce to address the serious, growing, and unmet need for mental and behavioral health services among children, adolescents, and young adults (C/A/YA) in the United States. See more →

April 22, 2019

Comments to the Health Resources and Services Administration expressing concerns from numerous organizations about HRSA’s latest behavioral health workforce projections and offering suggestions for future improvements in workforce estimates for behavioral health professionals caring for children, adolescents, and young adults. See more →

July 20, 2017

A letter to the House of Representatives in support of H.R. 3192, which would ensure access to mental health and substance use disorder prevention and treatment services for children under the Children’s Health Insurance Program (CHIP). See more →

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 →

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 →  

September 30, 2013

A letter from a group of organizations to Senators Max Baucus and Orrin G. Hatch in response to the Senate Finance Committee’s request on ways to improve the mental health system for Medicaid‐insured children and adolescents in the United States. See more →

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 →

by Harriette B. Fox, Margaret A. McManus, and Katherine N. Arnold, March 2010

Based on an original analysis of the 2007 Youth Risk Behavior Survey, this fact sheet provides national information on multiple health risk behaviors among high school students. It examines 12 types of significant health risk behaviors that include unsafe sexual behaviors, unhealthy eating and exercise patterns, mental health and substance use problems, and behaviors that contribute to violence. It reports on the prevalence and co-occurrence of these health risk behaviors and also differences by gender, race and ethnicity, and grade level. Implications for preventive interventions are also discussed. See more →

This press release describes a new grant award from the Lucile Packard Foundation for Children’s Health (LPFCH) to address the cliff that low-income youth with special health care needs (YSHCN) face as they age into adulthood and lose their child eligibility status in 4 major public programs: Medicaid, Children’s Health Insurance Program (CHIP), Supplemental Security Income (SSI) Program, and Title V Programs for Children with Special Needs. See more →

A guide containing a step-by-step approach for state Medicaid and managed care organizations (MCOs) as well as commercial payers interested in starting a VBP initiative around pediatric-to-adult transitional care. See more →

These business case statements offer a call to action for payers – both Medicaid and commercial insurers – to pay for pediatric-to-adult health care transition (HCT) services. They provide background information about HCT and a description of how payers can cover HCT services. These resources, which were produced with funding support from the Lucile Packard Foundation for Children’s Health, can be shared with payers to encourage payment for these services. Click here for a Medicaid version, and click here for a commercial payer version.

This report offers options of contract provisions that state Medicaid agencies and managed care organizations can use or adapt to improve the availability of pediatric-to-adult health care transition services. See more →

This policy brief shares a set of six opportunities for the Department of Health Care Finance to improve receipt of health care transition (HCT) services among publicly insured youth and young adults in the District of Columbia. See more →

The National Alliance to Advance Adolescent Health has received funding from the Lucile Packard Foundation for Children’s Health to develop a strategic dissemination plan to increase the use of value-based payment (VBP) and care delivery recommendations by payers for pediatric-to-adult health care transition. See more →

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 →

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 →

July 20, 2017

A letter to the House of Representatives in support of H.R. 3192, which would ensure access to mental health and substance use disorder prevention and treatment services for children under the Children’s Health Insurance Program (CHIP). See more →

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 →

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 →

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 →

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 →

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 →

by Harriette B. Fox and Margaret A. McManus, June 2009.
This issue brief documents the significant health risks and conditions of adolescents and the financing and delivery system barriers that affect their access to appropriate care. It urges Congress to consider coverage expansions under Medicaid and CHIP, benefit and payment improvements, grant programs to support interdisciplinary models of primary care, and funds to improve training for adolescent health providers. See more →

The National Alliance to Advance Adolescent Health/Got Transition has released two new reports and three policy briefs on the significant challenges and inequities that youth and young adults with disabilities face when aging out of Medicaid, CHIP, SSI, and Title V Programs.

This press release describes a new 5-year cooperative agreement from the federal Maternal and Child Health Bureau (MCHB) to the American Academy of Pediatrics (AAP) to form a new national center for the system of services for children and youth with special health care needs.. See more →

This press release describes a new grant award from the Lucile Packard Foundation for Children’s Health (LPFCH) to address the cliff that low-income youth with special health care needs (YSHCN) face as they age into adulthood and lose their child eligibility status in 4 major public programs: Medicaid, Children’s Health Insurance Program (CHIP), Supplemental Security Income (SSI) Program, and Title V Programs for Children with Special Needs. See more →

A guide containing a step-by-step approach for state Medicaid and managed care organizations (MCOs) as well as commercial payers interested in starting a VBP initiative around pediatric-to-adult transitional care. See more →

These business case statements offer a call to action for payers – both Medicaid and commercial insurers – to pay for pediatric-to-adult health care transition (HCT) services. They provide background information about HCT and a description of how payers can cover HCT services. These resources, which were produced with funding support from the Lucile Packard Foundation for Children’s Health, can be shared with payers to encourage payment for these services. Click here for a Medicaid version, and click here for a commercial payer version.

This press release explains the new grant award from the Maryland Department of Health's Office for Genetics and People with Special Health Care Needs to improve the transition of students with mental health conditions served by school mental health programs using Got Transition’s Six Core Elements of Health Care Transition. See more →

This press release describes a new grant award from the Lucile Packard Foundation for Children’s Health (LPFCH) to develop a health care transition measurement framework and a set of existing quality measures for use in pediatric-to-adult transitional care. See more →

This report offers options of contract provisions that state Medicaid agencies and managed care organizations can use or adapt to improve the availability of pediatric-to-adult health care transition services. See more →

by Margaret McManus, Patience White, Annie Schmidt, Michael Barr, Carolyn Langer, Kevin Berger, Allysa Ware. Health Policy OPEN. 2020;1:100007.

This article offers a series of implementation, payment, and research options to accelerate the adoption of recommended transition processes in both pediatric and adult systems of care. See more →

This policy brief shares a set of six opportunities for the Department of Health Care Finance to improve receipt of health care transition (HCT) services among publicly insured youth and young adults in the District of Columbia. See more →

by Annie Schmidt, Samhita Ilango, Margaret McManus, Katherine Rogers, Patience White. Journal of Pediatric Nursing. 2020;51:92-107.

This systematic review strengthens the evidence that a structured HCT process for youth with special health care needs can show improvements in adherence to care, disease-specific measures, quality of life, self-care skills, satisfaction with care, health care utilization, and HCT process of care. See more →

The National Alliance to Advance Adolescent Health has received funding from the WITH Foundation to improve the transition for young adults with intellectual and developmental disabilities (IDD) from pediatric to adult health care. The National Alliance will partner with The HSC Health Care System in Washington, DC to implement this first-of-its-kind transition value-based payment model. See more →

The National Alliance to Advance Adolescent Health has received funding from the Lucile Packard Foundation for Children’s Health to develop a strategic dissemination plan to increase the use of value-based payment (VBP) and care delivery recommendations by payers for pediatric-to-adult health care transition. See more →

February 15, 2019

The National Alliance to Advance Adolescent Health, along with a number of organizations, provides recommendations to the transition-related research theme of National Institute of Child Health and Human Development’s (NICHD) Strategic Plan for Fiscal Years 2020-2024. See more →

January 17, 2019

A letter with Public Comments to the Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for Healthy People 2030 on the proposed Healthy People 2030 objectives. See more →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →

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 →