Young adults are the first added to insurance rolls under health reform, but few know how the health system works. How do physicians manage these new patients? Jeremy Byrd, MD, a pediatric internist in Simpsonville, S.C., has been on a quest to reach a traditionally elusive group of patients -- young adults. [...] "I'm trying to get out there," Dr. Byrd said, "trying to attract young adults and educating them on the importance of seeing an established doctor, and the importance of preventative care."Part of the reason he is working so hard to attract younger patients is that, thanks to health system reform, there will be a whole lot more of them to attract.
One of the first provisions of the Patient Protection and Affordable Care Act allowed adults 26 and younger who do not have employer-sponsored health insurance to remain on or enroll in their parent's policy. Beginning in 2014, even young adults whose employer offers insurance will be eligible to join their parent's policy, and those without employer insurance also can buy coverage through an insurance exchange. In addition, single unemployed adults with limited income up to $15,000 per year (the income ceiling is higher for married young adults) will be eligible for health coverage through Medicaid.
Of the Americans who will gain insurance through health system reform, "we estimate that just over 7.5 million will be coming from the 19-26 segment," said Jean-Patrick Tsang, PhD, president of Bayser Consulting, a Wilmette, Ill.-based company that provides sales and marketing analysis for pharmaceutical, medical devices and diagnostics manufacturers. As a result, physician practices "will see a surge in patients age 26 and younger." A Commonwealth Fund report says 600,000 already had obtained new insurance coverage as of May. Before the surge, however, physicians will need to convince this age group that they need a regular doctor and preventive care, and let them know that they are now eligible for insurance coverage.
In addition, a tech-savvy generation comfortable with texting, social networking and online interaction will demand a certain level of service and technology to get them in the door and keep them coming back, experts said. What I kept hearing from [young adults] is that whenever they go to a physician, they feel like it's a formal, stiff interaction that focuses on their illness," said Dr. Byrd, who practices at four-physician Heritage Pediatrics & Internal Medicine. At the speed-dating event, "I think they enjoyed getting to know a doctor for a few minutes in a more casual, comfortable setting." And they were open to discussions on preventive care, he said.
For physicians like Dr. Byrd, the challenge is how to educate and reach young adults who may not know about the insurance option and who have different expectations and habits in terms of preventive care, service, access and communication. Seventy-three percent of young adults have little to no familiarity with the recent changes in health care regulations that allow dependents 26 or younger to stay on a parent's or guardian's health care plan, according to a Harris Interactive poll released in June conducted on behalf of the American Academy of Family Physicians.
In his experience, Dr. Byrd said, preventive care is not valued. "If you have a chronic illness, you know you need a doctor. Generally, people age 20 to 40 are healthy." Even if young adults are looking for medical care, it's not automatic that a physician's office will be the first place they go. According to a May 2011 report by PwC's Health Research Institute, 42% of consumers age 18 to 24 prefer to use an independent company, or one owned by a pharmacy, rather than a traditional doctor's office, compared with only 15% of consumers 55 and older who would go somewhere other than a physician practice. Part of what Dr. Byrd does in his hospital system's speed-dating sessions is sell young adults on the merits of having a steady relationship with a physician.
"It's important for [young adults] to establish care and follow up with their pediatrician [or other physician] before, during and after college," Dr. Byrd said. For college-age people, vaccines, such as meningococcal, DTaP and varicella, may require boosters. Ongoing care also is important for young adults as they become more s*xually active, he added. [...] Dr. Byrd said his practice gained at least one patient from the speed-dating event, and he is hopeful that the hospital will host more programs geared to young adults. "Once we started talking, [young adults] realized pretty quickly that they needed to be plugged in to a regular doctor," he said.
