Financial Cost of Healthcare Transition

  • Angelo P. Giardino


The finances for health-care transition (HCT) have long been recognized as a cornerstone of the care process. Each year about 500,000 AYASCHN reach adulthood, making efforts to determine how best to finance HCT imperative. Recognizing that effective HCT from pediatric to adult serving settings is a process not an event; the financing issues are complex. The current fee-for-service reimbursement model is more suited for counting events and paying for volume of care delivered rather than supporting a longitudinal care process that is more nuanced and embedded in a years-long set of conversations and activities among AYASHCN, their family, and health-care providers. Value-based initiatives that reimburse based on quality and outcomes rather than on discrete volumes of services may provide a financing vehicle where dollars saved via efficient care can be redirected to the HCT process, which would include the delivery of care in a patient- and family-centered medical home. Efforts are underway to develop, evaluate, and share best practices that incorporate both ideal care and appropriate financing to support that care.


Health-care costs Financing Medical home Alternative payment models 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Texas Children’s HospitalHoustonUSA
  2. 2.Academic General Pediatrics, Department of PediatricsBaylor College of MedicineHoustonUSA

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