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Pursuing value-based payment (VBP) options represents an important and timely opportunity to encourage improvements in pediatric and adult primary, specialty, and behavioral health care settings. This guide contains a step-by-step approach for state Medicaid and managed care organizations as well as commercial payers interested in starting a value-based payment initiative around pediatric-to-adult transitional care. Each of the steps includes several issues and strategies to consider, tips, and examples.