title: The Significant Impact of Different Insurance Enrollment Criteria on the HEDIS Chlamydia Screening Measure for Young Women Enrolled in Medicaid and Commercial Insurance Plans.
abstract: OBJECTIVE
  The impact of length of enrollment in a health plan on eligibility of women under the Healthcare Effectiveness Data and Information Set (HEDIS) chlamydia screening measure is not fully understood. We assessed the representativeness of the measure among the proportion of women aged 15 to 24 years with a gap in coverage for Medicaid and commercial health insurance.
  
  
  METHODS
  Truven Health Marketscan Medicaid and commercial health insurance data from 2006 to 2012 were used to make comparisons between proportions of women with a gap in coverage to those enrolled in insurance plans for different numbers of months.
  
  
  RESULTS
  Approximately 48% of Medicaid-insured women and 31% of commercially insured women had an at least 2-month gap that disqualified them from eligibility for inclusion in the HEDIS chlamydia screening measure. Extending eligibility to women with at least 6 months of coverage, regardless of gap, would increase the proportion of insured women included in the HEDIS measure to 76% (from 52%) for Medicaid and 83% (from 69%) for commercial insurance, without much effect on chlamydia testing rate. This would make the measure more representative of all insured women.
  
  
  CONCLUSIONS
  The large proportion of young women who had a 2-month or greater gap in coverage in Medicaid had a significant impact on the overall representativeness of the current HEDIS chlamydia screening measure.
authors.affiliation: From the *Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA; and †Oak Ridge Institute of Science and Education, Oak Ridge, TN.
authors.forename: Chirag G
authors.initials: CG
authors.lastname: Patel
authors.forename: Guoyu
authors.initials: G
authors.lastname: Tao
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis; D003955:Diagnostic Tests, Routine / Q000592:standards; D004608:Eligibility Determination; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D008329:Managed Care Programs; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D008484:Medicaid; D058996:Quality Improvement / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology; D014932:Women's Health Services / Q000191:economics / Q000706:statistics & numerical data*; D055815:Young Adult