Ensure the continuity of care for your teenage patients

During the transition from adolescence into adulthood, usually between the ages of 18 and 19, many Pediatric Primary Care Physicians inform their patients that they will no longer be able to serve as their Physician and ask them to secure a new Physician in an adult practice. After many years of being cared for by one Pediatric Physician, we recognize this can be an emotional time for everyone involved; however, Texas Children’s Health Plan is here to help. At Texas Children’s Health Plan, we are always looking ahead to ensure continuity of care for our members. One of the ways we do this is with our “Adolescent Transition” program. This program, which is available to both our CHIP and STAR members, is activated when the member reaches 15 years of age. Our team helps adolescent members and their families navigate the processes and responsibilities that come with “growing up.”

Transitioning to a new healthcare provider is not the only challenge faced by our maturing adolescent members. Changes in health care coverage is another area of need. CHIP members may no longer be eligible for Medicaid Managed Care coverage when they reach age 19. STAR members, on the other hand, may be eligible for continued Medicaid Managed Care coverage until they reach the age of 21. The Care Management Department contacts our members and their parents/guardians to raise awareness and to help begin planning for alternate sources of health care coverage in the future. Our goal is for every one of our members to leave Texas Children’s Health Plan without a gap in coverage.

If a parent, guardian, or Texas Children’s Health Plan member raises the discussion about Adolescent Transition, they may have already begun the process with one of our Case Managers. We have asked them to be proactive and begin planning. Once a member and their healthcare team have decided that the member needs to transition to an adult model of care, our Transition program will work to assist the member in locating adult providers which satisfy their health and geographic needs.

If you have any additional questions about the Adolescent Transition program, please contact the Care Management Department at 832-828-1430. We are here to help!

In addition, a great resource for information on the transition process is the website http://www.gottransition.org. It includes valuable tools to implement transition processes in the practice setting.