• The target trendline in the graph above represents an accepted national benchmark percentile for Medicaid programs across the country. The value graphed historically was the national 50^th percentile for comparison purposes. In 2020 (for measurement year 2019) we modified the value shown to demonstrate a target based on our actual performance.  For this measure, the target is the 50^th national percentile.
• The annual reported rate captures activity during the previous calendar year. 
• This is a Healthcare Effectiveness & Data Information Set (HEDIS) administrative measure.
• DVHA’s rates only include Medicaid Primary beneficiaries in HEDIS administrative measures.

This measure assesses the percentage of sexually active women 16-24 years of age who were screened for chlamydia during the measurement year. The Adult Core Set asks states to report the rate for the subset of women 21-24 years of age (shown above). 

Screening is essential because the majority of women who have the condition do not experience symptoms. The main objective of chlamydia screening is to prevent pelvic inflammatory disease (PID), infertility and ectopic pregnancy, all of which have very high rates of occurrence among women with untreated chlamydia infection.  Chlamydia trachomatis is the most common sexually transmitted disease (STD) in the U.S. Risk factors associated with becoming infected with chlamydia are the same risks for contracting other STD’s (e.g., multiple sex partners). Chlamydia is more prevalent among adolescent and young adult women.  

During Medicaid’s annual performance measure analysis in 2018, the Quality Committee, Managed Care Medical Committee and Clinical Utilization Review Board (CURB) chose the CHL measure for a quality improvement project as Vermont is currently performing below the Medicaid national 50^th percentile.  The project team included DVHA Quality Unit, Data Unit & Blueprint staff as well as VDH staff from Maternal and Child Health and Health Surveillance Divisions. The project team reviewed chlamydia screening data, research, and evidence-based interventions.  The team developed a charter and completed a fishbone diagramming the possible barriers to women receiving screening and heard from several subject matter experts on the topic.  A learning collaborative was then chosen as the primary intervention for the project. 

The team offered the learning collaborative through the Blueprint’s Women’s Health Initiative from April - November 2019.  The team recruited a variety of subject matter experts to speak on topics related to chlamydia screening and quality improvement.  The collaborative was a combination of eight 1.5-hour web-based learning sessions and action/measurement periods when practice teams met regularly to set goals, identify strategies, implement those strategies, and measure whether they had been successful.  

Five practices were recruited to participate in the collaborative. The project goal was to increase the HEDIS chlamydia screening rate of sexually active female Medicaid beneficiaries between the ages of 16-24.  The team understood that an intervention with only 5 practices would not move the needle in a statistically significant way on a statewide measure.  Three interim indicators were developed to assess the impact of the collaborative on the 5 participating practices.  Based on the results of the 3 interim indicators, DVHA believes that the practices who participated in the collaborative benefitted from the experience and were able to improve both their knowledge & screening rate on chlamydia. 

 Last updated:  August 2021