Enhancing Collaborations Between Public Health and Medicaid to Advance Innovative Approaches for Provision and Payment of STD Services

Background:  In 2013, the Association of State and Territorial Health Officials (ASTHO), in collaboration with national partners, examined the status of public health and healthcare integration for sexually transmitted disease (STD) services.  State/local jurisdictions reported that small grants would be helpful in advancing integration efforts, as resources would provide health agencies with opportunities to enhance relationships with healthcare partners.  In the second phase of this project, ASTHO, with support from the Centers for Disease Control and Prevention (CDC), funded state health agencies to explore collaborations between public health and payers (e.g., Medicaid).

Methods: In 2015, ASTHO funded the Mississippi, Rhode Island, and Washington state health agencies to advance innovative approaches to collaborating with Medicaid for provision/payment of STD services.  Grantees: 1) engaged key stakeholders; 2) assessed STD payment/delivery barriers; 3) participated in strategic planning meetings; and 4) produced action plans to guide implementation.  

Results:  Participating health agencies reported that grant funds were helpful in creating a space to engage Medicaid in assessing challenges and opportunities for enhanced provision of STD services.  Washington State explored establishing a data sharing agreement with Medicaid to collect STD screening/treatment data. Mississippi and Rhode Island explored implementing sustainable 3^rdparty billing structures for services provided at public health STD clinics.  Rhode Island assessed insurance status of patients at their state STD clinic and developed a cost analysis to prioritize action steps for increasing revenue.  Mississippi met with representatives from their state Medicaid office and identified opportunities to increase the reimbursement rate for public health STD services.

Conclusions:  Enhanced public health/Medicaid partnerships are critical for ensuring targeted delivery of, and sustainable payment for, STD services.  As Medicaid offices and STD programs evolve in the context of the Affordable Care Act, public health can engage Medicaid to identify challenges and mutually beneficial solutions.