The Commission continued its discussion on transitions from pediatric to adult care for Medicaid-covered children and youth with special health care needs (CYSHCN). MACPAC staff presented a draft chapter for the June 2025 report to Congress with four recommendations aimed at addressing challenges with and improving beneficiary experience with transitioning to adult care.
The chapter provides background on the Medicaid-covered CYSHCN population, the transition from pediatric to adult care process, and the availability of data on CYSHCN and transitions of care. The chapter then describes the current federal requirements and guidance related to CYSHCN transitions of care for state Medicaid and Title V agencies. Drawing on Commission discussions and findings from a state scan, state and stakeholder interviews, and beneficiary focus groups, the chapter describes the state’s role in transitions of care and key challenges with the current state transition of care strategies. The chapter includes the rationale and implications for Commission recommendations.