Screening and Treatment of Sexually Transmitted Infections among Medicaid Populations - A Two-State Analysis.

Merrell, Melinda A; Betley, Charles; Crouch, Elizabeth; Hung, Peiyin; Stockwell, Ian; Middleton, Alice; Pearson, William S

BACKGROUND Chlamydia, gonorrhea, and syphilis are common, treatable sexually transmitted infections (STIs) that are highly prevalent in the general U.S. population. Costs associated with diagnosing and treating these conditions for individual states' Medicaid participants are unknown. The purpose of this study was to estimate the cost of screening and treatment for three common STIs for state Medicaid program budgets in Maryland and South Carolina. METHODS A retrospective, cross-sectional study was conducted using Medicaid administrative claims data over a two-year period. Claims were included based on the presence of one of the three study conditions in either diagnosis or procedure codes. Descriptive analyses were used to characterize the participant population and expenditures for services provided. RESULTS Total Medicaid expenditures for STI care in state fiscal years 2016 and 2017 averaged $43.5 million and $22.3 million for each year in Maryland and South Carolina, respectively. Maryland had a greater proportion of costs associated with outpatient hospital and laboratory settings. Costs for care provided in the emergency department were highest in South Carolina. CONCLUSIONS Diagnosis and treatment of commonly reported STIs may have a considerable financial impact on individual state Medicaid programs. Public health activities directed at STI prevention are important tools for reducing these costs to states.