title: Improving Receipt and Preventive Care Delivery for Adolescents and Young Adults: Initial Lessons from Top-Performing States.
abstract: Purpose Provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 hold promise for improving access to and receipt of preventive services for adolescents and young adults (AYAs). The Title V Block Grant transformation also includes a focus on improving adolescent preventive care. This brief report describes and discusses an inquiry of promising strategies for improving access and preventive care delivery identified in selected high-performing states. Methods Two data sources were used to identify top-performing states in insurance enrollment and preventive care delivery: National Survey of Children's Health for adolescents (ages 12-17 years) and Behavioral Risk Factors Surveillance System for young adults (ages 18-25 years). Interviews were conducted with key stakeholders to identify promising strategies related to increasing AYAs' insurance enrollment and receipt of preventive services. Results Seven top-performing states were selected: California, Colorado, Illinois, Iowa, Oregon, Vermont, and Texas; 27 stakeholders completed interviews. Four strategies were identified regarding insurance enrollment: use of partnerships; special populations outreach; leveraging laws and resources; and youth engagement. Four strategies were identified regarding quality preventive care: expand provider capacity to serve AYAs; adopt medical home policies; establish quality improvement projects; and enhance consumer awareness of well-visit. States focused more on adolescents than young adults and on increasing health insurance enrollment than the provision of preventive services. Conclusions This commentary identifies strategies and recommends areas for future action, as Title V programs and their partners focus on improving healthcare for AYAs as ACA implementation and the Title V transformation continues.
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.|Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
authors.forename: Claire D
authors.initials: CD
authors.lastname: Brindis
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA. Lauren.Twietmeyer@ucsf.edu.
authors.forename: Lauren
authors.identifier: 0000-0002-6038-9439
authors.initials: L
authors.lastname: Twietmeyer
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Park
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Adams
authors.affiliation: Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, 3333 California Street, Suite 245, San Francisco, CA, 94118, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Irwin
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health; D008297:Male; D058991:Patient Protection and Affordable Care Act; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Adolescents; Affordable Care Act; Preventive care; Title V Block Grant transformation; Well-visit; Young adults