title: Changes in Young Adult Primary Care Under the Affordable Care Act.
abstract: OBJECTIVE
  We sought to describe changes in young adults' routine care and usual sources of care (USCs), according to provider specialty, after implementation of extended dependent coverage under the Affordable Care Act (ACA) in 2010.
  
  
  METHODS
  We used Medical Expenditure Panel Survey data from 2006 to 2012 to examine young adults' receipt of routine care in the preceding year, identification of a USC, and USC provider specialties (pediatrics, family medicine, internal medicine, and obstetrics and gynecology).
  
  
  RESULTS
  The percentage of young adults who sought routine care increased from 42.4% in 2006 to 49.5% in 2012 (P < .001). The percentage identifying a USC remained stable at approximately 60%. Among young adults with a USC, there was a trend between 2006 and 2012 toward increasing percentages with pediatric (7.6% vs 9.1%) and family medicine (75.9% vs 80.9%) providers and declining percentages with internal medicine (11.5% vs 7.6%) and obstetrics and gynecology (5.0% vs 2.5%) providers.
  
  
  CONCLUSIONS
  Efforts under the ACA to increase health insurance coverage had favorable effects on young adults' use of routine care. Monitoring routine care use and USC choices in this group can inform primary care workforce needs and graduate medical education priorities across specialties.
authors.affiliation: Charlene A. Wong is with the Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, and the Division of Adolescent Medicine, The Children's Hospital of Philadelphia. Carol A. Ford is with the Division of Adolescent Medicine, Children's Hospital of Philadelphia, University of Pennsylvania. Benjamin French is with the Department of Biostatistics and Epidemiology, University of Pennsylvania. David M. Rubin is with the Division of General Pediatrics, PolicyLab, Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Wong
authors.affiliation: Charlene A. Wong is with the Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, and the Division of Adolescent Medicine, The Children's Hospital of Philadelphia. Carol A. Ford is with the Division of Adolescent Medicine, Children's Hospital of Philadelphia, University of Pennsylvania. Benjamin French is with the Department of Biostatistics and Epidemiology, University of Pennsylvania. David M. Rubin is with the Division of General Pediatrics, PolicyLab, Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Ford
authors.affiliation: Charlene A. Wong is with the Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, and the Division of Adolescent Medicine, The Children's Hospital of Philadelphia. Carol A. Ford is with the Division of Adolescent Medicine, Children's Hospital of Philadelphia, University of Pennsylvania. Benjamin French is with the Department of Biostatistics and Epidemiology, University of Pennsylvania. David M. Rubin is with the Division of General Pediatrics, PolicyLab, Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: Benjamin
authors.initials: B
authors.lastname: French
authors.affiliation: Charlene A. Wong is with the Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, and the Division of Adolescent Medicine, The Children's Hospital of Philadelphia. Carol A. Ford is with the Division of Adolescent Medicine, Children's Hospital of Philadelphia, University of Pennsylvania. Benjamin French is with the Department of Biostatistics and Epidemiology, University of Pennsylvania. David M. Rubin is with the Division of General Pediatrics, PolicyLab, Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: David M
authors.initials: DM
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D018802:Patient-Centered Care / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult