Health Aff (Millwood). 2014 Mar;33(3):482-6. doi: 10.1377/hlthaff.2013.1131.
People who have served time in US prisons and jails have high rates of undiagnosed chronic and infectious diseases, behavioral health conditions, and trauma. Because a large portion of this population are young men-a demographic previously underrepresented in Medicaid rolls-who have been uninsured, Medicaid payers and the managed care plans they contract with have little experience serving this population. To meet the Affordable Care Act's policy objectives of cost-efficient and effective care through improved and expanded access, health plans need to understand the epidemiology and care-seeking patterns of this population. Plans also need to develop outreach, communications, and engagement strategies and create service models designed to address these individuals' health care needs. Corrections departments and health plans should exchange information about the medical histories of people entering and leaving prisons and jails, promote models of peer support, and advocate for suspension rather than termination of Medicaid benefits during incarceration, so inmates can quickly regain coverage once they are released.
曾在美监狱服刑的人员患有大量未确诊的慢性和传染性疾病、行为健康问题和创伤，这一比例很高。由于这部分人群中很大一部分是年轻男性——此前在医疗补助计划中代表性不足的群体——他们没有医疗保险，因此医疗补助支付者及其签约的管理式医疗计划在为这部分人群提供服务方面经验有限。为了实现《平价医疗法案》通过改善和扩大获得服务的机会来实现成本效益和有效的护理的政策目标，医疗计划需要了解这一人群的流行病学和寻求护理的模式。计划还需要制定外展、沟通和参与策略，并创建旨在满足这些人医疗保健需求的服务模式。惩教部门和医疗计划应交流有关进出监狱人员的医疗史信息，推广同伴支持模式，并倡导在监禁期间暂停而不是终止医疗补助福利，以便囚犯一旦获释就能迅速获得覆盖。
