Protecting Adolescent Confidentiality Under Health Care Reform: The Special Case Regarding Explanation of Benefits (EOBs), K.P. Tebb, E. Sedlander, G. Pica, A. Diaz, K. Peake & C.D. Brandis (2014)

This report focuses on the confidentiality concerns for dependent adolescents and young adults using health insurance. According to the report, adolescents and young adults are more likely to seek health services, disclose health risk behaviors to a clinician, and return for follow-up care adults when they are assured of confidentiality. Concerns about potential confidentiality breaches can result in delayed or forgone care, which can lead to serious consequences, including unprotected sex, unintended pregnancy, untreated STIs, and mental health issues. Adolescents most at risk are even more likely to forgo care because of confidentiality concerns than their lower-risk peers. As a result, major health organizations recommend that adolescents have access to comprehensive confidential health services. Despite these recommendations, few teens report having time alone with their clinician for confidential health discussions. Other teens and young adults turn to public health safety net funds or free clinics to receive confidential care.

Using interviews with clinicians, health care administrators, health plan representatives, adolescent health advocates, researchers and policy experts, this report examines the ways in which “Explanation of Benefits” (EOB) statements, issued by insurance companies, can breech the confidentiality of medical care that adolescents rely on, especially when dealing with contraception and other sexual health issues.

The report outlines a number of different approaches to dealing with EOBs that attempt to balance the need to communicate information with the primary policyholder, with the need for the confidentiality of insured dependents who seek sensitive health services.