Medi-Cal HMOs did not consistently use prevention, screening and treatment guidelines for chlamydia and gonorrhea prior to the 2002 implementation of the Chlamydia Quality Initiative, a study by the University of California-Los Angeles Center for Health Policy Research found. Researchers said Medi-Cal HMOs have "shown significant improvement" in Health Plan Employer and Data Information Set chlamydia screening measures since implementation of the initiative.
For the study, researchers surveyed Medi-Cal HMOs, medical groups and primary care physicians in the eight California counties with the highest incidence of chlamydia and the greatest number of Medi-Cal beneficiaries. The survey was conducted as part of the Chlamydia Quality Initiative.
The study found that:
- More than two-thirds of HMOs had recommendations for annual chlamydia screening for females ages 15 to 25 who are sexually active, but in half of those HMOs, fewer than 25% were screened;
- About 60% of medical groups had recommendations similar to HEDIS for annual chlamydia screening, but in half of those medical groups, fewer than 25% of patients were screened;
- Solo-practice PCPs had a lower rate of guideline adherence than group- or clinic-based PCPs;
- Female PCPs adhered to the guidelines more often than male PCPs;
- PCPs with higher volume of Medi-Cal beneficiaries had higher adherence than PCPs with lower volumes of beneficiaries; and
- PCPs with recent training on sexually transmitted infections or who received feedback from their HMO or medical group on STI practices had higher adherence than PCPs with no recent training or who received little feedback from their HMO or medical group.