An Analysis of Preventative Health for Adolescents With MassHealth Insurance

While most adolescents living in the United States enjoy good health and disease-free states, evidence suggests that subsets of this population do not. For many adolescents residing in lower income families, the story is different. Health risks are increased in this adolescent subgroup likely as a result of the various social inequities placed upon them. Preventative health strategies employed during adolescence may play a key role in reducing, delaying, or solving the chronic health and social conditions often experienced in our society’s lower income individuals. Access to healthcare delivery is essential to these adolescents as providers deliver preventive healthcare during comprehensive well visits. Unfortunate disparities in care delivery for low-income adolescents are identified in the healthcare policy literature. Multiple factors, including insurance coverage and access to care, help to explain these differences in care for adolescents (Leininger & Levy, 2015). Access to care is a key factor in reducing health disparities and influencing health (Lau, Lin, & Flores, 2012).

In Massachusetts, access to healthcare services for adolescents from lower income families is linked to having MassHealth (Medicaid) insurance coverage. A policy analysis approach was utilized for this DNP project to explore and analyze the current status of adolescent preventative healthcare under MassHealth. The Bardach Eightfold Path for Policy Analysis framework was used to guide exploration of the current status of preventative healthcare for adolescents covered by MassHealth. Access, cost, and quality (central tenets of health policy) and principles of health equity supported the data collection and analysis. Key findings of this policy analysis suggest that barriers exist in access to care for this population including insurance acceptance by providers, appointment times, travel and lack of transport services, and lack of care coordination that provides interpreters and support to adolescents navigating healthcare.

To reduce these barriers, improve access to comprehensive preventative care, and reduce risk for poor health and illness, healthcare delivery providers and organizations in Massachusetts need to place priority on adolescent healthcare services. New innovative programs that enhance existing resources such as school-based health clinics and behavioral health education should be designed and implemented. Community-based programs where health education and healthcare delivery are combined should be supported. Strong advocacy is needed to promote the delivery of adolescent preventative healthcare in these inclusive, convenient, and community-based settings. To ensure optimal patient outcomes and to support access to care for low-income families and their children, health policies in Massachusetts need to ensure that health insurance coverage is secured. Insurance programs such as MassHealth should support engagement of parents and stakeholders to be certain that preventative healthcare is prioritized for adolescents. For lower income families, it is essential to work toward closing the gaps that exist as a result of unfavorable social environments.

Addressing these recommendations will help toward creating a culture where adolescents from low-income families thrive and their health improves. Ignoring these opportunities will likely result in the perpetuation of health inequities and the continuation of rising healthcare cost with associated poor outcomes and poor health.

Advanced practice nurse leaders can play a key role in advancing preventative health in Massachusetts, improving health outcomes and decreasing healthcare costs.