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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Targeted Reforms in Health Care Financing to Improve the Care of Adolescents and Young Adults
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Targeted Reforms in Health Care Financing to Improve the Care of Adolescents and Young Adults

机译：卫生保健融资的有针对性的改革，改善青少年和年轻成人的照顾

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Significant changes have occurred in the commercial and government insurance marketplace after the passage of 2 federal legislation acts, the Patient Protection and Affordable Care Act of 2010 and the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Despite the potential these 2 acts held to improve the health care of adolescents and young adults (AYAs), including the financing of care, there are barriers to achieving this goal. In the first quarter of 2016, 13.7% of individuals 18 to 24 years of age still lacked health insurance. Limitations in the scope of benefits coverage and inadequate provider payment can curtail access to health care for AYAs, particularly care related to sexual and reproductive health and mental and behavioral health. Some health plans impose financial barriers to access because they require families to absorb high cost-sharing expenses (eg, deductibles, copayments, and coinsurance). Finally, challenges of confidentiality inherent in the billing and insurance claim practices of some health insurance plans can discourage access to health care in the absence of other obstacles and interfere with provision of confidential care. This policy statement summarizes the current state of impediments that AYA, including those with special health care needs, face in accessing timely and appropriate health care and that providers face in serving these patients. These impediments include limited scope of benefits, high cost sharing, inadequate provider payment, and insufficient confidentiality protections. With this statement, we aim to improve both access to health care by AYAs and providers' delivery of developmentally appropriate health care for these patients through the presentation of an overview of the issues, specific recommendations for reform of health care financing for AYAs, and practical actions that pediatricians and other providers can take to advocate for appropriate payments for providing health care to AYAs.
机译：在2010年联邦立法法案，2010年患者保护和实惠的护理法案和2008年的Paul Wellstone和Pete Domenici精神健康阶段和成瘾股权法案之后，在商业和政府保险市场中发生了重大变化。尽管有潜在的这些2持有改善青少年和年轻人（AYAS）的医疗保健的行为，包括护理融资，有障碍实现这一目标。 2016年第一季度，13.7％的人18至24岁仍然缺乏健康保险。福利范围的局限性覆盖范围和提供者不足的付款可以减少对Ayas的医疗保健，特别是与性健康和心理和行为健康有关的护理。一些健康计划将财务障碍施加到抵销，因为他们要求家庭吸收高成本共享费用（例如，扣除，共同投资和Coillance）。最后，在计费和保险索赔的情况下固有的保密性挑战可以在没有其他障碍的情况下劝阻获得医疗保健，并干扰提供机密护理。本政策声明总结了AYA，包括特殊医疗保健需求的障碍状态，在提供及时和适当的医疗保健方面，以及提供这些患者的提供者面临的障碍。这些障碍包括有限的福利范围，成本高，提供商支付不足，保密性保护不足。通过这一声明，我们的目标是通过介绍问题的概述，为AYAS改革改革的具体建议，改善对这些患者的对这些患者的发育适当的医疗保健的机会适当的医疗保健的进展。儿科医生和其他提供商可以采取倡导适当的付款，以便为AYA提供保健的适当付款。

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