As your teen navigates their transition into adulthood, there is one important task the family should not forget—helping your teen transfer their care from their pediatrician to an adult primary care provider.
Parents are responsible for managing their child’s visits to a pediatrician from birth. But when the child turns 18, parents can no longer be intermediaries for medical care (except in special cases) to comply with the rules set out by the Health Information Portability and Accountability Act (HIPAA). As an adult, an 18-year-old must take on that responsibility.
ONLY ABOUT 20% OF YOUTHS IN THE U.S. RECEIVED NECESSARY HEALTHCARE TRANSITION PREPARATION.
Source: Trends and Disparities in Health Care Transition Preparation from 2016 to 2019: Findings from the US National Survey of Children’s Health
Pediatricians at UHS are ready to help each family and young adult patient make the necessary changes to their care team. Mary DeGuardi, MD, director of UHS Pediatrics in Binghamton, says many patients have a fairly seamless transition to an adult care medical team. “Because we are part of a large multispecialty group that provides pediatric care, adult medicine care, gynecologic and obstetric care, we have an opportunity to help our patients navigate this transition.”
MILESTONES FOR CARE TRANSITIONS
Parents and older teens should have a plan in mind for how and when medical care responsibilities will shift. Here are some guidelines that can help:
Ages 16–17
- Encourage your teen to make their own doctor appointments.
- Ask the pediatrician to talk with your teen about privacy rights when they turn 18.
- Work with your teen and pediatrician to make and share a medical summary.
- Before they turn 18, figure out if your child needs help making healthcare decisions.
- Talk with your teen about the age they want to transfer to a new primary care provider.
Ages 18–21
- At age 18, your child is a legal adult and legally responsible for their healthcare. Parents cannot access their medical information or be in the physician visit unless the teen agrees.
- Encourage your teen to ask their current pediatrician for help finding a new adult provider.
- Parents and young adults should discuss how insurance and copayments work.
Accounting for special needs
Dr. DeGuardi also notes it is important to understand how a young person’s medical needs affect how they make their transition to adult care providers. “For patients who have special needs, such as developmental or intellectual disabilities, patients with autism, ADHD, Crohn’s disease, cystic fibrosis, cardiac disease and so on, we want to make sure that these patients don’t fall through the cracks,” she says.
“We want to be sure they receive ongoing, quality care, so we recommend adult care providers who we think would be a good fit for their medical needs.”
“In the last four or five years, the UHS Medical Group has made more of an effort to enhance that communication between the UHS pediatric providers and the UHS adult medicine providers so we can make the transition smoother, especially for the patients who have special needs,” adds Dr. DeGuardi.
Young patients with chronic or ongoing conditions may also have pediatric subspecialists—such as endocrinologists or pulmonologists—managing their care, and those providers also have to transfer to adult care specialists. It would ease those transitions if they don’t all happen at once; Dr. DeGuardi recommends staggering those new relationships to ensure a smooth transition.
Don’t let things slide
For teen patients who are in good health, they may not feel much pressure to formalize their medical care changes, but it is still important. With high school graduation and other big milestones around age 18, young adults might let this drop low on their to-do list.
“That’s often a time when we will have that conversation: ‘Have you thought about what you’re going to do about your ongoing medical care?’ Because some kids are going away to college, others are staying in town, but either way, that 18th birthday is when, if you want your parents to still have access to your medical records, you have to give them permission because of HIPAA,” says Dr. DeGuardi.
“That’s usually when the lightbulbs go on, and they ask me, ‘How long can I still see you?’”
Dr. DeGuardi says it’s perfectly fine for patients to remain with her until age 21 if they choose, and most UHS pediatricians follow that rule of thumb. But some pediatricians may draw a hard line at 18, so be prepared and ask questions early.
Dr. DeGuardi advises her young adult patients about who a good primary care provider would be for them, but UHS care coordinators are also available to help find a new provider and make first appointments. “In the end, it’s really going to be the patient’s choice,” Dr. DeGuardi emphasizes. “We just want to make sure they don’t have years without seeing a provider for a routine well check because medical issues can go undetected. If somebody goes several years without medical care, it could cause more of a problem than if it was detected early.”
THE RIGHT FIT
Find a UHS primary care provider at nyuhs.org/care-treatment.
