Health Savings Account - Eligible High Deductible Health Plans: Updating the Definition of Prevention

High-deductible health plans (HDHPs) are an important and growing part of the health insurance landscape. By some estimates, as many as 80 percent of large employers may offer an HDHP in 2014. In 2013, more than 15 million Americans received health coverage through an HDHP, a more than a threefold increase since 2007.As outlined by the U.S. Treasury Department, individuals with an HSA-eligible HDHP are required to pay the full cost of most medications and services -- in theory utilizing pre-tax HSA funds -- until deductibles are met. However, the 2003 authorizing legislation and further guidance include a safe harbor allowing plans to cover primary preventive services, those typically deemed to prevent the onset of disease, before the deductible is satisfied.Services or benefits meant to treat "an existing illness, injury or condition," are excluded from first-dollar coverage in HSA-eligible HDHPs, which encompasses most secondary preventive services. For example, plans are prohibited from providing first dollar coverage of disease management services such as insulin, eye and foot exams, and glucose monitoring supplies for patients with diabetes.As chronic disease conditions currently make up 75 percent of total U.S. health spending, appropriate chronic disease management is an important tool to lower long-term health care costs. As the market for HDHPs grow, it is important that they maintain the flexibility to allow for effective health management of all beneficiaries. This report addresses the strict definition of prevention that an HDHP must follow for it to include a pre-tax health savings account (HSA), and how this restriction limits the effectiveness of current plans. A potential solution - allowing HSA-eligible HDHPs to provide first-dollar coverage for targeted, evidence-based, secondary preventive services that prevent chronic disease progression and related complications - can improve patient-centered outcomes, add efficiency to medical spending, and enhance HDHP attractiveness.A multi-disciplinary research team from the University of Michigan's Center for Value-Based Insurance Design, Harvard Medical School, and the University of Minnesota conducted a multi-part project to investigate the impact of updatingthe definition of prevention for HDHPs to include selected secondary preventive services that are frequently used as health plan quality metrics and included as elements of pay-for-performance programs. Specifically, the project aimed to: 1) determine the premium effect, actuarial value, and estimated market uptake of the novel HDHP plan that covers these evidence-based services outside the deductible, and 2) explore through interviews whether insurance industry experts found coverage of secondary preventive services a worthwhile endeavor

Teenage parents

Teenage pregnancy is considered to be one of the most important adolescent health problems in Western society. It is associated with a high economic cost involving both direct monetary expenditure for public assistance for welfare and child health care as well as negative societal outcomes in terms of child abuse, neglect and poverty (Quinlivan, 2004). Australia now has one of the highest adolescent fertility rates in the world. Teenage mothers may experience a number of adverse outcomes associated with teenage pregnancy including failure to complete schooling, inability to find a job, and increased risk of poor health (Quinlivan, 2004; Social Exclusion Unit, 1999). There is now considerable evidence that many teenagers idealise pregnancy and parenthood and regard it with high expectations. A significant proportion of adolescent pregnancies result as a consequence of positive, idealised attitudes to pregnancy, parenthood and personal change rather than by accident or negative attitudes to contraception (Condon et al., 2001)

for African-American Youth

with a Complementary Program for Parent

Embryo donation parents' attitudes towards donors : comparison with adoption

BACKGROUND: Embryo donation produces a family structure where neither rearing parent is genetically related to the child, as in adoption. It is not known how embryo donation parents view the donors compared with how adoptive parents view the birth parents. METHODS: 21 couples with an embryo donation child aged 2–5 years were compared with 28 couples with an adopted child. Parents were administered a semi-structured interview, assessing knowledge of the donors/birth parents, frequency of thoughts and discussions about the donors/birth parents and disclosure of the donor conception/adoption to the child. Comparisons were made between mothers and fathers to examine gender differences. RESULTS: Embryo donation parents generally knew only the donors’ physical characteristics, and thought about and talked about the donors less frequently than adoptive parents thought about and talked about the birth parents. Embryo donation fathers tended to think about the donors less often than did mothers. Disclosure of the child's origins in embryo donation families was far less common than in adoptive families (P < 0.001 for mothers and fathers), and was associated with the level of donor information (P < 0.05 for mothers, P < 0.025 for fathers). CONCLUSIONS: Embryo donation parents’ views on the donors differ from adoptive parents’ views on the birth parents, with donors having little significance in family life once treatment is successful

When a Parent Is Incarcerated: A Primer for Social Workers

Offers guidance on meeting the needs of children of incarcerated parents, including reducing trauma, engaging incarcerated parents, re-entry planning, addressing domestic violence, and issues for parents in deportation proceedings. Includes resource list

Parents Anonymous Outcome Evaluation: Promising Findings for Child Maltreatment Reduction

Parents Anonymous(R) mutual support groups for parents are aimed at strengthening families and reducing child maltreatment. NCCD performed a national evaluation to assess whether parent participation in Parents Anonymous(R) was associated with change in child maltreatment outcomes and in risk and protective factors. The study sought to answer the question: Does Parents Anonymous(R) work to reduce the risk of child maltreatment and, if so, for all parents or for some more than others?The results of this evaluation show that parents were positively affected in a variety of important ways by their experience with Parents Anonymous(R)