Current primary care models are inadequate for adults on the autism spectrum. The Center for Autism Services and Transition (CAST) clinic was developed in 2014 using feedback from parents of adults on the autism spectrum and patient-centered medical home principles. We evaluated the reach of CAST's services. As of January 2021, 858 patients were seen in CAST. Many continue to receive primary care from the CAST clinic. The program has undergone staffing changes but continues to accept new patients. We have added services such as "happy visits," pre-procedure videos, and telehealth visits. CAST provides one example of how to improve primary care for adults on the autism spectrum. More research is needed to assess the effectiveness of the CAST model. Keywords Transition to adult care • Primary care • Adolescent • Young adult • AutismAround the world, approximately 1% of adults are on the autism spectrum (Baxter et al., 2015;Brugha et al., 2011;Dietz et al., 2020), and a large number of people on the autism spectrum will be reaching adulthood over the next 5 to 10 years (Van Naarden Braun et al., 2015). The transition to adulthood in general and from pediatric to adult health care specifically are challenging for many young adults (Bonnie et al., 2015). The legal changes that begin at age 18 such as only sharing medical information with the patient, which are meant to protect a patient's privacy, can also create communication barriers for young people whose parents are regularly involved in conversations about medical care, and this is especially problematic for young people on the autism spectrum (Cheak-Zamora & Teti, 2015). Additionally, young adults on the autism spectrum have to navigate disruption of support services upon exiting the school system and changes in insurance eligibility that occur between
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