Public-Private Partnership Increases Chlamydia Screening in Medicaid Managed Care Population

Background: Annually, 75% of Michigan’s chlamydia (CT) cases are diagnosed in the private sector.  In 2008, 52% of Michigan’s CT cases were reported in southeastern Michigan, inclusive of the City of Detroit, while the population in this area accounted for only 32% of the State’s residents.  The rate per 100,000 population for CT in Detroit is almost four times that of the State’s overall rate. Thus, the Michigan Department of Community Health partnered with Molina Healthcare of Michigan to launch the Chlamydia Practice Improvement Project (CPIP).   CPIP adapted a proven effective culturally specific intervention model.  Molina had 9,000 Medicaid enrolled females that year, age 16-24; 50% resided in the target area. Medicaid HEDIS results showed 54.7% of members age 16-24 were screened for CT statewide while the average screening rate for CPIP intervention sites was only 42.55%.

Objectives: To increase CT screening among female members age 16-24.

Methods: Intervention sites were selected based on size of member population, as well as screening and positivity rates. All sites received On-site Provider Meetings to discuss CT screening, assess barriers to screening, and develop improvement plans.  Site progress was shared during follow-up visits. Site performance was assessed via claims data.

Results: From 2009-2010, intervention sites experienced an average increase of 14% in screening rates. During that time, Molina’s statewide rate remained level. As a result of the intervention, 150 cases of CT were identified.  Additionally, an estimated $73,646 in medical costs associated with treatment of pelvic inflammatory disease, were averted. 

Conclusions: Molina’s providers improved screening coverage, avoided sequalae of CT, and improved their HEDIS measurement; resulting in healthier Michiganders.

Implications for Programs, Policy, and Research: Full implementation of the Affordable Care Act will move more STD services to private sector providers.  Partnerships like CPIP can ensure screening remains available to high risk populations.