Adolescent Medicine at the Crossroads: A Review of Fellowship Training and Recommendations for Reform

by Harriette B. Fox, Margaret A. McManus, Jane E. Wilson, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Jonathan D. Klein, and Charles J. Wibbelsman, April 2008

This special report examines the current state of adolescent medicine fellowship programs. It contains information on the supply and recruitment of fellows; the nature and content of clinical, research, and leadership training; the institutional and financial challenges facing training programs today; and offers recommendations for building the field. Information was obtained primarily from a national survey of adolescent medicine fellowship program directors, along with key informant interviews, and an extensive literature review.

Under One Roof: Primary Care Models That Work for Adolescents

by Marian Sandmaier, Alyssa D. Bell, Harriette B. Fox, and Margaret A. McManus, May 2007

This report describes a model of comprehensive, interdisciplinary physical, behavioral, and reproductive health care for adolescents operating in 3 different health care settings — a hospital outpatient department, office practice, and community health center. The strengths and flexibility of the 3 models are profiled in detail, along with the financing challenges these programs confront. Information was obtained through a site visit and multiple telephone interviews with the programs' providers and administrators.

Is the Health Care System Working for Adolescents?  Perspectives from Providers in Boston, Denver, Houston, and San Francisco

by Margaret A. McManus, Kandi I. Shejavali, and Harriette B. Fox, October 2003

This report provides a comprehensive assessment of how well adolescents in four urban areas are being served by the current health care system.  It contains provider perspectives on the extent to which preventive and primary care, reproductive care, and behavioral health care adequately meet adolescents’ needs and the main organizational, health insurance, managed care, and other factors facilitating or impeding access to these services.  The report also includes recommendations for organizing and financing an optimal health care system for adolescents. Information was obtained primarily from on-site interviews with health care providers.

Eligibility, Benefits, and Cost-sharing in Separate SCHIP Programs

by Harriette B. Fox, Ruti G. Levtov, and Margaret A. McManus, October 2003

This report describes eligibility, benefit, and cost-sharing policies in 36 separate SCHIP programs.  Detailed state tables are included on SCHIP and Medicaid income eligibility levels, SCHIP benefit policies, and premium, copayment, and coinsurance amounts.  The information is based on an analysis of state plan documents, managed care contracts, and provider and member manuals, as well as telephone interviews and email correspondence with state SCHIP agency staff.

Private Health Insurance for Adolescents: Is It Adequate?

by Harriette B. Fox, Margaret A. McManus, and Mary B. Reichman, September 2002

This report examines the extent of private health insurance coverage available for services required by 6 hypothetical adolescents with different health conditions: asthma, attention deficit hyperactivity disorder, injury, major depressive disorder, pregnancy with sexually transmitted infections, and substance abuse with bipolar disorder.  The analysis considers the availability of the benefit, access restrictions and protections relevant to the adolescent’s condition, and limits in amount and duration of coverage. Information for the study was obtained from contract documents for the most commonly sold HMO and PPO product in each state.