Increased Number of Sexually-Active Women and Women Who Had Chlamydia Testing in HEDIS Measures, 2009-2014

Background:  Chlamydia testing has been used in the Healthcare Effectiveness Data and Information Set (HEDIS), one of the most widely used set of healthcare performance measures in the United States, since 2000. Although chlamydia testing rates increased significantly from 2000-2007 and slowly changed in the recent several years, the number of sexually-active women and the number of women who had chlamydia testing have never been examined.

Methods:  We analyzed the 2009-2014 HEDIS data on the chlamydia testing measure. Chlamydia testing rate was calculated as the proportion of sexually-active women aged 16-24 years who had chlamydia testing in any given year.

Results:  Overall chlamydia testing rates have varied from 56% to 59% among women aged 16-24 years in Medicaid health plans and from 40% to 48% in commercial health plans during 2009-2014. The number of sexually-active women increased 61%, from 618,000 in 2009 to 999,000 in 2014 in Medicaid health plans and 21%, from 2.4 million in 2009 to 3.1 million in 2014 in commercial health plans.  The number of women who had chlamydia testing increased from 358,000 in 2009 to 560,000 in 2014 in Medicaid health plans and from 1.1 million in 2009 to 1.5 million in 2014 in commercial health plans.  The proportion of sexually-active women aged 16-24 years who were aged 21-24 years varied from 38%-40% in Medicaid health plans and from 49%-55% in commercial health plans during 2009-2014.

Conclusions:  Although chlamydia testing rates did not increase substantially during 2009-2014 and the current rates were suboptimal, the number of sexually-active women and the number of women who had chlamydia testing has increased substantially from 2009 to 2014. Our data may indirectly reflect the impact of the Affordable Care Act (ACA) on the increased number of young women who were newly insured.