• is low, it may be appropriate for STD-related services to be delivered by alternate providers.
  • Protect confidentiality of STD-related services. MCOs and other providers of STD-related services should safeguard the confidentiality of STD-related services, especially for adolescents. States that do not have laws ensuring complete confidentiality of STD-related services for adolescents should consider them.
  • Train providers. Health care providers, including those in MCOs, are not adequately trained in the spectrum of STD-related services. MCOs should provide training to their staff in both curative and noncurative preventive health, especially management of high-risk behaviors.
  • Tailor MCO services for high-risk groups. The general managed care packages of services developed for commercial populations may not be appropriate for indigent populations. MCOs and other providers should develop the capacity to address the unique needs of the high-risk populations that they serve. MCOs that serve indigent populations and others at high risk for STDs will need to tailor the traditional package of health services for commercial populations to the health care needs of high-risk populations.
  • Educate policymakers. Local, state, and federal policymakers in private and public health agencies and organizations should be educated regarding the issues associated with managed care in STD prevention. Local health departments, in particular, should develop expertise on issues related to managed care and public health. In addition, legislators at all levels should have a good understanding of these issues.
  • Conduct further research. Many policy and funding decisions regarding STD-related programs are being made in the absence of good data on program effectiveness. Additional research regarding the effectiveness of various interventions in STD prevention needs to be conducted to support data-based decision-making. A mechanism for sharing information and experiences regarding effective or innovative STD prevention programs should be developed. Information on "best practices" should be available to all stakeholders in STD prevention. Evaluation or research components should be built into public/private partnerships.
  • Explore new sources of funding. New sources of funding for STD-related services should be considered. One potential source of funding for public health programs is payments assessed against publicly funded nonprofit hospitals and health plans that convert to for-profit status. Another potential source is a "tax" levied on MCOs and health insurance companies to pay for public health activities that benefit their enrolled populations.

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