This article conceptualizes necrotizing enterocolitis (NEC) as a chronic condition with lifelong gastrointestinal, neurodevelopmental, and psychosocial sequelae. Current fragmented health care systems inadequately serve NEC survivors and their families after Neonatal Intensive Care Unit (NICU) discharge. Drawing on conceptual frameworks in life course development, chronic disease management, and care coordination for children with medical complexity, we propose an adaptive, tiered framework for post-discharge collaborative care. Three tiers, Standard Enhanced Follow-up, Moderate Complexity Coordination, and Intensive Multidisciplinary Co-Management, align care intensity with patient complexity and include criteria for escalation and de-escalation. This approach emphasizes structured NICU-to-primary care transitions, subspecialty integration, and family-centered coordination.