Provision of sexual health services to adolescent enrollees in Medicaid managed care

Objectives. This Seattle project measured sexual health services provided to 1112 Medicaid managed care enrollees aged 14 to 18 years. Methods. Three health maintenance organizations (HMOs) that provide Medicaid services for a capitated rate agreed to participate. These included a non-profit staff-model HMO, a for-profit independent practice association (IPA), and a non-profit alliance of community clinics. Analyses used health maintenance organizations' administrative data, chart reviews, and Medicaid encounter data. Results. Health maintenance organizations provided primary care to 54% and well care to 20% of Medicaid enrollees. Girls were more likely than boys to have their sexual history taken or to be given condom counseling. Only 27% of sexually active girls were tested for chlamydia, with significantly lower rates of testing among those who spoke English as a second language. The nonprofit staff-model plan outperformed the for-profit independent practice association on most measures. Conclusions. Substantial room for improvement exists in sexual health services delivery to adolescent Medicaid managed care enrollees.