Value-Based Payment to Support Health Care Transition for Young Adults with Intellectual and Developmental...

Area of Science:

• Health Services Research
• Health Care Transition
• Intellectual and Developmental Disabilities

Background:

• Limited health care transition (HCT) preparation (20%) for youth with intellectual and developmental disability (ID/DD).
• A novel HCT value-based payment (VBP) pilot was implemented to address system gaps.

Purpose of the Study:

• To assess the feasibility, acceptability, and expansion potential of an HCT VBP pilot for young adults (YA) with ID/DD.
• To identify benefits and challenges of the VBP model in a specialty Medicaid managed care setting.

Main Methods:

• Feasibility study conducted within a Medicaid managed care organization (HSCSN).
• Intervention included a structured HCT process with VBP incentives.
• Data collected via YA feedback surveys and interviews with stakeholders.

Main Results:

• High satisfaction reported by YA with ID/DD, caregivers, and healthcare providers (HCPs).
• Benefits included improved patient engagement and care management; challenges involved care management support and scheduling.
• Nine YA with ID/DD participated in the pilot.

Conclusions:

• The HCT VBP approach is feasible and acceptable, addressing an unmet need.
• Streamlined care management, medical summary preparation, and adequate payment are crucial for expansion.
• Future expansion requires payer/HCP collaboration and improved system technology.