Delivery of Sexually Transmitted Disease Services in Medicaid Managed Care

Publication Date: June 2000

Publisher: UCLA Center for Health Policy Research

Author(s): John Nakashima; Nadereh Pourat; Natasha Razack; E. Richard Brown

Research Area: Health

Keywords: Medicaid; STD

Type: Report

Coverage: California

Abstract:

This report examines the extent to which managed care organizations (MCOs) that serve Medicaid beneficiaries are promoting effective management, control and prevention of sexually transmitted diseases (STDs) among their enrollees -- and whether these organizations' policies correspond with the actual practices of the primary care providers in their networks.

In 1996 alone, 15.3 million new STD cases were reported in the United States, and the prevalence of these infections is even higher due to the accumulation of viral non-treatable STD cases. Beyond the suffering caused directly by a particular disease, STDs can lead to infertility, pregnancy complications, cancer, and a greater susceptibility to HIV infection, among other complications. The advent and dramatic growth of Medicaid managed care plans increases the importance of MCOs' policies and programs to combat STDs, particularly since the Medicaid population of mostly low-income women and children includes a large proportion of individuals who are considered at higher risk for STDs.

For this report, the authors focused on MCOs that serve Medicaid beneficiaries in metropolitan areas with a high prevalence of STDs, and looked at the extent to which STD practice guidelines are promoted by MCOs and by their contracted medical groups (CMGs) and used by the CMGs' affiliated primary care providers (PCPs).