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Paying for the Transition from Pediatric to Adult Health Care

Organization: National Alliance to Advance Adolescent Health

Primary Contact: Peggy McManus

Grant Amount: $133,572 for 21 months

Date Awarded:

Purpose

Lack of payment is one of the most significant barriers to providing quality transition services for youth with special health care needs. Billing codes are not specific to transition, and transition services often are not required in managed care contracts. Based on a previous report recommending value-based transition payment, this grant will enable the National Alliance to Advance Adolescent Health to identify and assist commercial insurers and Medicaid programs to pilot test alternative payment strategies. The funding also will support development of related communication and technical assistance materials to be disseminated nationally.

Outcome

The National Alliance to Advance Adolescent Health (NAAAH) identified and engaged eight commercial insurers and Medicaid programs to pilot test alternative payment strategies. A value-based payment guide, as well as two related webinars, were developed and disseminated. NAAAH also provided technical assistance that was highly valued by participants. Genuine progress was made in two large programs, in Texas and Florida, and further work is planned.