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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Transition.

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Strategy. State Policy/System Development

Approach. Partner with organizations to encourage adoption of evidence-driven health care transition (HCT) practices and policies

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Overview. State Policy and System Development strategies are essential for creating sustainable infrastructure to support healthcare transition (HCT) for youth with special health care needs. Effective implementation requires partnerships with diverse organizations including family and youth organizations, disability groups, state agencies, payers, health plans, and school systems, which have shown increased knowledge of and adoption of evidence-driven HCT practices and policies.[1] Title V programs can play a leadership role by convening stakeholders, facilitating cross-sector collaboration, and advocating for policy changes that support transition services. These efforts may include developing state-level transition standards, integrating transition planning into quality metrics for health plans, establishing reimbursement mechanisms for transition services, and creating accountability frameworks. System-level changes can address challenges such as fragmented care delivery, lack of provider training, and inadequate insurance coverage for transition-age youth. By building policy infrastructure and fostering organizational partnerships, states can create an enabling environment where evidence-based HCT practices become standard across all healthcare settings.

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Partnership engagement and activity tracking
  • Qualitative evaluation feedback from partner organizations
  • Tracking data on documentation of evidence-driven HCT adoption of partner organization

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of organizations engaged as partners to promote HCT practices and policies. (Measures extent of coalition-building efforts)
  • Number of HCT-related training sessions for technical assistance provided to partner organizations. (Measures capacity-building activities)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of HCT resources and training materials developed with input from youth and family partners. (Measures level of engagement for co-design and co-production of HCT resources)
  • Percent of partner organizations actively participating in an HCT learning collaborative for community of practice. (Measures engagement in shared learning)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of policymakers and decision-makers educated on HCT best practices and policy options through partner channels. (Measures reach of education efforts from HCT educators)
  • Number of partner-developed HCT stories, case studies, and successes showcased and disseminated. (Measures the reach and amplification of best practices)
  • Number of HCT measures and standards incorporated into partner organizations' performance monitoring systems. (Measures accountability integration)
  • Number of partner organizations contributing data to a statewide HCT quality dashboard for report. (Measures collective impact of HCT activities across partnerships and collaborations)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of partners with an explicit commitment to HCT practices and outcomes in their policies for strategic plans. (Measures integration of practices into partner operations and priorities)
  • Percent of partners contributing to a policy agenda that advances HCT for youth with complex health and social needs. (Measures strategic alignment on importance of HCT across partners)
  • Percent of partner organizations contributing data to a statewide HCT quality dashboard for report. (Measures collective impact of HCT activities across partnerships and collaborations)
  • Percent of transition-age youth with disabilities for complex needs in the state who achieve successful transfer of care to adult system. (Measures the success of HCT programming for CYSHCN on a population level)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 White PH, Cooley WC, Transitions Clinical Report Authoring Group, American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians. Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics. 2018;142(5):e20182587

Note: Got Transition is now offering the updated Six Core Elements of Health Care Transition™ 3.0, https://gottransition.org/six-core-elements/ which define the basic components of HCT support. The Six Core Elements 3.0 are intended for use by pediatric, family medicine, med-peds, and internal medicine practices.To help practices transform their HCT processes, Got Transition has also developed new practical step-by-step Implementation Guides dedicated to each core element. Got Transition offers background information on how to use the Implementation Guides, as well as a Quality Improvement Primer for those unfamiliar with the QI process. Guides and information are available at www.GotTransition.org/Implementation.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.