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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Jas Nagra, MPH, CHES1, George W. Rutherford, MD1, Gail Bolan, MD2, Richard Battaglia, MD FACP3, Romni Neiman2, Barry Handon, MD, MPH4, and Heidi Bauer, MD, MS, MPH2. (1) California Chlamydia Action Coalition, University of California, San Francisco, 1947 Center Street, Suite 201, Berkeley, CA 94704, 510-540-2758, jnagra@dhs.ca.gov, (2) STD Control Branch, California Department of Health Services, 1947 Center St. #201, Berkeley, CA 94704, (3) Healthcare Consulting Practice, PreicewaterhouseCoopers, LLP, 3600 HSBC Center, Buffalo, NY 14203, (4) Medi-Cal Managed Care Division, California Department of Health Services, 714 P Street, Room 650, Sacramento, CA 95814
Background: Managed care organizations (MCOs) have the capacity to promote and facilitate screening and treatment of large numbers of individuals at risk for chlamydia infections; therefore, their involvement is central to statewide chlamydia reduction efforts. The California Chlamydia Action Coalition (CCAC) has recognized the importance of managed care involvement and has initiated several collaborative activities with both commercial and Medicaid managed care plans.
Content: Sexually transmitted chlamydia infection is the most common reportable disease in California with an estimated incidence of 600,000 per year. Annual screening of sexually active women 15-25 years old became a HEDIS indicator in 1999. To address this public health need, CCAC has undertaken several initiatives that focus on improving screening rates in MCOs and subsequent treatment and partner management. In partership with PricewaterhouseCoopers, LLP we developed a clinical practice guideline for screening and treatment of asymptomatic chlamydia infection. The development process brought together leaders from health plans, medical groups and public health agencies. To facilitate implementation of the clinical practice guideline we also developed the Chlamydia Care Quality Improvement Toolbox as a resource to accompany the guidelines. The toolbox consists of the following sections: clinical practice guidelines (including a separate guideline for diagnosis and treatment of chlamydia in pregnancy), screening tests for chlamydia, sexual history taking, public health laws and regulations related to chlamydia, CDC STD Guidelines, chlamydia quality improvement activities and NCQA, provider education materials and patient education materials. The toolbox addresses some of the barriers experienced by patients, providers, and health plans – barriers that potentially impact the degree to which chlamydia screening is performed. We sent the toolbox to commercial and Medicaid MCOs, medical groups and independent practice associations, professional societies, academic medical centers, and various state and federal agencies. ”Academic detailing” of managed care organization leaders was initiated in order to secure adoption of the guideline by as many MCOs as possible.
In addition to our quality improvement activities, CCAC is leading the planning and development of a chlamydia data warehouse that will receive chlamydia test results from laboratories and provide data to MCOs for HEDIS reporting and prevalence monitoring and to public health agencies for disease reporting purposes.
Implications for Research: Future research and evaluation will monitor the effectiveness or our comprehensive and collaborative approach and will focus on the outcomes of chlamydia incidence, chlamydia prevalence, rates of complications of chlamydia infections and provider screening and prescribing practices.
Learning Objectives:
Keywords: Quality Improvement, Public/Private Partnerships
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.