Developing Academic Detailing and Patient Empowerment for Addressing Private Practice Chlamydia Screening and Treatment

Background: Routine provider adherence to screening recommendations, including chlamydia screening, is paramount to the sexual and reproductive health of young women, yet screening rates remain subpar. Although changing screening practices of private providers can be a daunting task for Public Health, improvement in these settings is key. Partnering with a health plan with established relationships with these providers may provide the leverage needed to shift behavior.

Methods:  The Pennsylvania STD Program (PASTD) was approached by Geisinger Health Plan (GHP) for methods to improve performance on the Healthcare Effectiveness Data and Information Set (HEDIS) measure of chlamydia screening among young women. GHP agreed to provide PASTD with 2016 HEDIS data for that measure; in collaboration with the GHP quality assurance and informatics teams, PASTD identified private providers with an annual chlamydia screening rate below the Pennsylvania state average for possible intervention via public health detailing.  

Results:  Overall, 532 practices consisting of 813 providers were identified via HEDIS data.  Practices included as highest priority for intervention were designated as: (1) practices not owned by GHP and (2) practices with less than 30 patients.  From those (n=48 practices; n=148 providers), 12 sites with the lowest screening rates, or the bottom 25% of final data set, have been targeted for intervention. HEDIS screening rates among targeted practices range from 13.51% to 31.43%.  

Conclusions:  Improving screening rates among private providers through collaboration with a health plan is an underused methodology. Fully engaging a health plan partner requires buy-in by the plan’s quality assurance team. This requires substantial effort on the part of public health to build consensus regarding activities, outcomes, and plan involvement; develop intervention materials; and provide evidence-based methods to implement change. Obtaining and utilizing HEDIS data can direct this conversation and identify practices to target for evaluation and education.