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

Profile of California's HMO Enrollees: Findings from the 2001 California Health Interview Survey

The profile of California’s 17.7 million children and adults who are enrolled in HMO plans is more diverse than previously thought, according to the UCLA Center for Health Policy Research report. The report provides a more refined population-based profile of California’s HMO population than has previously been available, using data from the 2001 California Health Interview Survey (CHIS 2001). The report findings suggest that differences in language fluency and educational attainment of California’s HMO population present potential barriers for some HMO members in understanding HMO policies and programs. Funded by the California Office of the Patient Advocate (OPA), the report provides statewide and regional profiles of HMO enrollees and their socioeconomic characteristics, medical conditions and health status, health risk factors, and access to and utilization of health care. Key demographic findings about HMO enrollees statewide include: * Twenty-seven percent (27%) are immigrants, including 15% who are naturalized citizens and 12% who are noncitizens; * Thirty-four percent (34%) communicate at home in a language other than English or solely in another language; * Thirty-five percent (35%) of adults ages 18-64 and 45% of adults ages 65 and over have a high-school education or less; and, * Forty-one percent (41%) are nonwhite, including 19% Latino, 12% Asian American and Pacific Islander, and 7% African American

Profile of California's HMO Enrollees: Findings from the 2001 California Health Interview Survey

The profile of California’s 17.7 million children and adults who are enrolled in HMO plans is more diverse than previously thought, according to the UCLA Center for Health Policy Research report. The report provides a more refined population-based profile of California’s HMO population than has previously been available, using data from the 2001 California Health Interview Survey (CHIS 2001). The report findings suggest that differences in language fluency and educational attainment of California’s HMO population present potential barriers for some HMO members in understanding HMO policies and programs. Funded by the California Office of the Patient Advocate (OPA), the report provides statewide and regional profiles of HMO enrollees and their socioeconomic characteristics, medical conditions and health status, health risk factors, and access to and utilization of health care. Key demographic findings about HMO enrollees statewide include: * Twenty-seven percent (27%) are immigrants, including 15% who are naturalized citizens and 12% who are noncitizens; * Thirty-four percent (34%) communicate at home in a language other than English or solely in another language; * Thirty-five percent (35%) of adults ages 18-64 and 45% of adults ages 65 and over have a high-school education or less; and, * Forty-one percent (41%) are nonwhite, including 19% Latino, 12% Asian American and Pacific Islander, and 7% African American

Delivery of Sexually Transmitted Disease Services in Medicaid Managed Care

This report examines the extent to which managed care organizations (MCOs) that serveMedicaid beneficiaries are promoting effective management, control and prevention of sexuallytransmitted diseases (STDs) among their enrollees—and whether these organizations’ policiescorrespond with the actual practices of the primary care providers in their networks.In 1996 alone, 15.3 million new STD cases were reported in the United States, and theprevalence of these infections is even higher due to the accumulation of viral non-treatable STDcases. Beyond the suffering caused directly by a particular disease, STDs can lead to infertility,pregnancy complications, cancer, and a greater susceptibility to HIV infection, among othercomplications. The advent and dramatic growth of Medicaid managed care plans increases theimportance of MCOs’ policies and programs to combat STDs, particularly since the Medicaidpopulation of mostly low-income women and children includes a large proportion of ind ividualswho are considered at higher risk for STDs

Effects of Community Factors on Access to Ambulatory Care for Lower-Income Adults in Large Urban Communities

This study examines the effects of community-level and individual-level factors on access to ambulatory care for lower-income adults in 54 urban metropolitan statistical areas in the United States. Drawing on a conceptual behavioral and structural framework of access, the authors developed multivariate models for insured and uninsured lower-income adults to assess the adjusted effects of community- and individual-level factors on two indicators of access: having a usual source of care, and having at least one physician visit in the past year. Several community factors influenced access, but they did so differently for insured and uninsured adults and for the two measures of access used. The findings of this study confirm that public policies and community environment have measurable and substantial impacts on access to care, and that expanded public resources, such as Medicaid payments and safety-net clinics, can lead to measurable improvements in access for vulnerable populations residing in large urban areas