599 - Navigation Hub: A Centralized Support for Transferring Adolescents and Young Adults

Poster Number: 599
Publication Number: 599.403

Courtney L. Porter, Children's Hospital Los Angeles, Los Angeles, CA, United States; Rachel Cuevas, Children's Hospital Los Angeles, Downey, CA, United States; Ellen Iverson, Children's Hospital Los Angeles/University of Southern California, Culver City, CA, United States; Jennifer Baird, Children's Hospital Los Angeles, Los Angeles, CA, United States; Jesus Escobar, Children's Hospital Los Angeles, Los Angeles, CA, United States; Roberta G. Williams, Children's Hospital Los Angeles/, Los Angeles, CA, United States

Background: Adolescents and young adults (AYA) with chronic conditions face challenges transitioning from pediatric to adult health care systems including lack of logistical support with identifying appropriate adult providers, communicating with insurers, and transferring care to new providers. Pediatric clinicians lack expertise in these systems-coordination skills and dedicated time to provide this level of care coordination.

Objective: The purpose of this project was to evaluate initial implementation of a centralized care coordination support for AYA patients and their families to navigate insurance and benefits systems and transfer to adult providers.

Design/Methods: Within the context of an institution-wide approach to transition support, we designed and implemented the Navigation Hub. Case managers meet with patients to identify patient priorities, explore provider availability within insurer’s network, and assist with transfer-related coordination and establishment of service with benefit programs. Support continues until transfer-related goals are achieved. To ensure continuous refinement, we surveyed providers whose patients had accessed the hub at three months and one-year post-implementation. Patients and families were surveyed after goals were achieved.

Results: Launched in September 2020, the hub now supports 10 subspecialty clinics with the goal of expansion across the institution. To date, 351 patients have been supported. Assistance includes transfer to adult providers (71.6%); insurance (55.3%) and public benefits navigation (15.8%); and guidance with conservatorship/healthcare power of attorney (11.1%). Providers (n=33) reported high levels of satisfaction with ease of referring patients, communication with the hub, and quality of services. Patients (n=13) and parents/guardians (n=16) indicated high levels of satisfaction with services and communication and time spent with case managers. All patients reported increased confidence calling providers' offices, knowing how to access medical records and benefits information, asking adult providers questions, and completing healthcare-related forms. Nearly all (88.9%) indicated increased confidence knowing where to find insurance information.Conclusion(s): The Navigation Hub fills a critical gap in the care delivery system for AYA transitioning to adult providers by removing transfer-related care coordination activities from pediatric providers to a centralized group with coordination expertise. Ongoing evaluation will serve to standardize coordination processes, identify activities of greatest value and support long-term financial viability.