Adolescent enrollees in Medicaid managed care: The provision of well care and sexual health assessment

Purpose: (1) To estimate the proportion of adolescents receiving outpatient care, well care, and sexual health assessment during 12 months of continuo us enrollment in Medicaid managed care. (2) To investigate factors associat ed with provision of these categories of service. Methods: Chart reviews were completed for a statewide random sample of adol escent Medicaid enrollees in Washington State. Multivariate logistic regres sion models included age, gender, race, language, residence, enrollment pla n, and service level as independent variables. Dependent variables were rec eipt of outpatient care, well care, and sexual health assessment. Results: Of 2000 enrollees' records, 78.3% provided evidence of outpatient service, 30.5% included well care, and 20.8% documented a sexual health ass essment. Among adolescents who obtained service, younger enrollees and non- Whites were more likely to receive well care; females, older enrollees, and those with well care were more likely to have sexual health assessments. U se of standardized charting tools increased the likelihood that sexual heal th assessments would be documented. The variable most strongly associated w ith provision of outpatient service was plan of enrollment. Plan rankings o n provision of outpatient care were not associated with organizational desc riptions, such as for-profit status or plan structure. Conclusion: The low rates of well care and sexual health assessment documen ted for adolescents in Medicaid managed care suggest that interventions are needed. (C) Society for Adolescent Medicine, 2001.