Got Transition’s Six Core Elements of Health Care Transition in Medicaid Managed Care
State/Jurisdiction: District of Columbia
Topic Area: Access to Health Care/Insurance, Service Coordination & Integration,
NPMs: NPM 12: Transition
Although most managed care plans have an organized process for hospital to home transitions, few have a systematic process in place for transition from pediatric to adult health care. With funding from the DC Department of Health Title V Program, Got Transition (operated by The National Alliance to Advance Adolescent Health) began a transition pilot project in Washington, DC to improve this transition to adult care in Health Services for Children with Special Needs (HSCSN), a DC-based managed care plan with 6,000 enrollees (from birth to age 26). The "Got Transition's Six Core Elements of Health Care Transition in Medicaid Managed Care" project incorporated the Six Core Elements of Health Care Transition into a Medicaid managed care plan by customizing and integrating transition core elements within a Medicaid plan's existing care management processes. After customizing the Six Core Elements and recruiting pediatric and adult practices, the program piloted the new transition process and tools with a group of 35 young adult enrollees with chronic mental health, developmental, and complex medical conditions.
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