Medicaid Managed Care Plan Provides Reports, Guidelines, and Education Materials to Physicians, Reducing Inappropriate Prescribing of Antibiotics to Children and Adolescents

Snapshot

Summary
As part of a collaborative with four other California health plans, Health Net of California's Medi-Cal managed care plan provided physicians with a quarterly report that benchmarks individual performance related to prescribing of antibiotics to treat upper respiratory infection (i.e., the common cold) in children and adolescents versus that of peers, along with a list of child and adolescent patients of that physician who may have been inappropriately prescribed antibiotics for such an infection in the past year. The collaborative also provided an educational toolkit to network physicians that included copies of relevant adult and pediatric practice guidelines related to treatment of upper respiratory infection and other common viral infections not amenable to antibiotic treatment; posters, brochures, and other materials to educate patients and parents on appropriate prescribing; and pads that allow physicians to give parents a "prescription" consisting of instructions on how to treat their child's cold with over-the-counter medications and home-based therapies. The program significantly reduced inappropriate prescribing of antibiotics for upper respiratory infections in children and adolescents. The collaborative addressing appropriate prescription for those diagnosed with upper respiratory infections ended in 2010 when stated goals were achieved. However, collaborating health plans continue to implement specific activities within their population to sustain improved outcomes. Health Net continues to send the provider quarterly reports, and in 2012 began including patients 18 to 64 years old who were diagnosed with acute bronchitis and inappropriately prescribed with antibiotics.
Evidence Rating (What is this?)
Moderate: The evidence consists of pre- and post-implementation trends in the prescribing habits of physicians for children and adolescent patients diagnosed with URI, along with post-implementation survey feedback from participating physicians.

Developing Organizations
Health Net of California, Inc.

Patient Population
The program targeted children between the ages of 3 months and 18 years old.Age > Adolescent (13-18 years); Child (6-12 years); Vulnerable Populations > Children; Age > Infant (1-23 months); Insurance Status > Medicaid; Age > Preschooler (2-5 years)