Seiler Naomi, Horton Katie, Organick-Lee Paige, Washington Mekhi, Turner Taylor, Pearson William S
Department of Health Policy and Management, George Washington University School of Public Health, 950 New Hampshire Ave NW, Washington, DC 20037. Email:
Am J Manag Care. 2024 Dec 1;30(12):e341-e344. doi: 10.37765/ajmc.2024.89641.
The US is facing a growing epidemic of sexually transmitted infections (STIs), with over 2.5 million cases of chlamydia, gonorrhea, and syphilis reported in 2021 and again in 2022. This public health crisis disproportionately affects youth and racial and ethnic minority communities, exacerbating barriers to accessing sexual health services. Untreated STIs can lead to severe health consequences, including infertility, pelvic inflammatory disease, and increased risk of HIV transmission and acquisition. Managed care organizations (MCOs) within Medicaid play a pivotal role in improving sexual health service delivery and addressing the rise in STIs. This commentary explores opportunities for Medicaid MCOs to enhance STI prevention, screening, and treatment. It was informed by reviews of Medicaid managed care contracts, plan provider manuals, and interviews with Medicaid plan officials and other experts. It presents a set of opportunities to enhance STI prevention, including incentivizing syphilis screening during pregnancy through existing perinatal and maternal health efforts, leveraging extended postpartum coverage for sexual health education, integrating STI services with substance use disorder programs, supporting community-based organizations that serve relevant communities, training community-facing workers in STI care and sexual health, coordinating with local health departments, and providing enrollee access to condoms and home STI tests. Implementing these strategies could reduce STI rates and improve health outcomes, particularly among vulnerable populations. Although this commentary draws on research focused on Medicaid MCOs, a coordinated approach that includes commercial plans and coordination with health departments could ultimately enhance the consistency and quality of STI services and sexual health care across the health care system.
美国正面临性传播感染（STIs）疫情的不断蔓延，2021年和2022年报告的衣原体、淋病和梅毒病例均超过250万例。这场公共卫生危机对年轻人以及种族和少数族裔社区的影响尤为严重，加剧了获得性健康服务的障碍。未经治疗的性传播感染可导致严重的健康后果，包括不孕、盆腔炎，以及增加艾滋病毒传播和感染的风险。医疗补助计划中的管理式医疗组织（MCOs）在改善性健康服务提供和应对性传播感染增加方面发挥着关键作用。本评论探讨了医疗补助计划管理式医疗组织加强性传播感染预防、筛查和治疗的机会。它参考了对医疗补助管理式医疗合同、计划提供者手册的审查，以及对医疗补助计划官员和其他专家的访谈。它提出了一系列加强性传播感染预防的机会，包括通过现有的围产期和孕产妇健康工作激励孕期梅毒筛查，利用延长的产后覆盖范围进行性健康教育，将性传播感染服务与物质使用障碍项目相结合，支持为相关社区服务的社区组织，培训面向社区的工作人员进行性传播感染护理和性健康培训，与当地卫生部门协调，以及为参保人提供避孕套和家庭性传播感染检测。实施这些策略可以降低性传播感染率，改善健康结果，特别是在弱势群体中。尽管本评论借鉴了针对医疗补助计划管理式医疗组织的研究，但包括商业计划以及与卫生部门协调在内的协调方法最终可以提高整个医疗保健系统中性传播感染服务和性健康护理的一致性和质量。
