Sexually Transmitted Disease Services in California's Medi-Cal Managed Care: Findings From a Baseline Survey of STD Care Delivery in 2002

In California, chlamydia and gonorrhea are the most common reportable sexually transmitted diseases (STDs). Medi-Cal, California's version of the Medicaid program, serves a population that is socio-demographically similar to the general at-risk STD population. While managed care enrollment provides a unique opportunity to encourage a public health approach to disease prevention and health promotion, little is known about the recommendations of STD guidelines and whether primary care providers (PCPs) follow these guidelines in Medi-Cal managed care. This report discusses the findings of a baseline survey of health maintenance organizations (HMOs), medical groups, and primary care physicians in Medi-Cal managed care conducted as part of a Medi-Cal chlamydia quality improvement initiative to assess STD recommendations and practices. Eight California counties with the largest numbers of Medi-Cal beneficiaries and largest numbers of chlamydia cases were surveyed. The survey examined factors likely to impact PCP practices. The findings of this report reflect the delivery of STD care before the initiative was implemented throughout the state