Young Adult Health Care Survey (YAHCS)

The Young Adult Health Care Survey (YAHCS) is a teen survey that assesses whether young adults (ages 14 to 18) are receiving nationally-recommended preventive services during a well-care visit. Nine quality measures of care can be gathered and scored using the YAHCS, which measure the presence, helpfulness and experience of preventive screening and counseling in a private and confidential setting. The YAHCS also gathers information useful for quality improvement and community assessment, including questions about:

  • Teen health (items derived from the Child Health and Illness Profile-Adolescent Edition (CHIP-AE©) about health status and exercise)
  • Teen participation in risky behaviors (items derived from the Center for Disease Control’s Youth Behavior Surveillance Survey)
  • Teen’s health care utilization (last regular or routine care visit, place of regular or routine care, whether the teen filled out a checklist about his/her health at the health care provider’s office)
  • Access issues (problems getting necessary care)

The YAHCS is endorsed by the National Quality Forum (NQF) as a valid measure for system- and plan-level assessment. The YAHCS has been implemented nationally and in at least 5 state Medicaid programs, with over 10,000 surveys gathered. This survey can be administered by mail or phone and is available in both English and Spanish.

The Need for the Survey

The YAHCS was designed to measure the communication-dependent aspects of care during the well-care visits through a patient-reported measure. Adolescents are shown to be a reliable reporter of what happens during these health care visits and are more appropriate than relying on medical chart reviews, claims and billing data as they do not capture the relational portion of the well-care visit.

Although there are measures that provide information about how many adolescents have been to the doctor for a well care visit, such as the Health Plan Employer Data and Information Set (HEDIS®), these do not address the quality of these well care visits. The YAHCS provides information regarding the experience of the well care visits to determine if adolescents are receiving the recommended care.

Implementation Materials

Applications in the Field

  • Five health plans (four in California, one in New York) as part of their quality improvement projects.
  • The state of Washington as part of its Medicaid quality improvement efforts. The state did sampling at a county-level and analysis at the health plan level. Read a detailed report of the findings from Snohomish County.
  • Florida, as part of its KidCare evaluation, conducted by the Institute for Health Care Policy.
  • The Department of Medicaid Managed Care in New York to inform quality improvement activities for teens and to explore the possible use of the YAHCS for quality assurance reporting.
  • Datastat implemented the YAHCS for California’s Managed Risk Medical Insurance Board (MRMIB) to assess the quality of care provided to teens in the S-CHIP program in 21 health plans.
  • The Maternal & Child Health Policy Research Center will be using the YAHCS benchmark database as part of an issue brief focused on the current state of care and opportunities for strengthening Medicaid/SCHIP benefits for adolescents
  • The Robert Wood Johnson Foundation produced a data portrait of adolescents in 2001 from a nationwide online teen sample using a majority of the items from the YAHCS.

Additional Information

  • A report on the survey design and evaluation.
  • A presentation giving a general overview of the YACHS and the results from Snohomish County’s implementation.

In Partnership With: The David and Lucile Packard Foundation / The Commonwealth Fund / The Foundation for Accountability (FACCT) / YAHCS Measurement Advisory Group / Over 50 organizations representing consumers, providers, policy makers and research organizations (e.g. Children Now, AAP, AMA) / Dozens of adolescents through their participation in interviews and focus groups.