Gateway Health’s Promising Practices in Vaccinating Dually Eligible Members

Date: October 20, 2021
Time to read: 6 minutes.

In the blog post below, Gateway Health’s Manager of Clinical Care Coordination, Kelli Volpert, RN shares her organization’s promising practices to promote COVID-19 vaccinations among their Medicare and Medicaid beneficiaries.

Gateway Health provides health care benefits to vulnerable communities across Pennsylvania (PA). When the COVID-19 vaccination became available, we recognized the important role we had to play in ensuring our members have access to the vaccine, both to protect themselves and to protect our community. Knowing that COVID-19 disproportionately impacts older adults and individuals with physical and developmental disability, and that these individuals face significant challenges accessing vaccination sites and services, we relied on our existing care coordination strategies and network of community partners to promote COVID-19 vaccinations among these vulnerable populations.

We found the following strategies to be successful in our efforts:

  • Launched Gateway Health Connection Centers to host vaccination clinics. In Spring 2021, we launched two Connection Centers in Pittsburgh and Harrisburg, PA to provide members access to in-person guidance and programs that support holistic health. We learned from collaboration between various providers, community-based organizations, as well as community-based case management outreach that face-to-face intervention had a huge impact on closing care gaps and preventing utilization. To determine where to establish the Connection Centers, we began by looking at central geographic locations in which we had a higher density of membership. In hope to make a bigger impact, we also looked at various neighborhoods where we knew members that are at higher risk for having multiple care gaps and social determinants of health needs reside. Once we pulled the various data points, we then looked at locations within the neighborhood that were easily accessible to public transit. Our Centers provide members with access to care management and care coordination, member service support, as well as events and workshops, including COVID-19 vaccination clinics. We found it helpful to have a centralized location to refer our members to for vaccinations, and the Centers allowed us to connect individuals to other beneficial services and supports.
  • Use of Case Managers for vaccination outreach and promotion. Our team of Case Managers has been critical in helping to communicate important COVID-19 vaccination information to our members. We incorporated COVID-19 vaccination questions into our Case Manager scripts so that at every touchpoint (whether it was COVID-19-related or not), we do not miss an opportunity to connect someone to vaccination services. Example questions include:
    • “Have you been vaccinated?”
    • “Are you interested in receiving the vaccination?”, and
    • “What barriers are preventing you from getting vaccinated?”

Members often shared barriers we did not expect. For example, we heard that limited available parking deterred some members from attending one of our vaccination sites. To address this, we proactively coordinated with the facility to offer temporary parking during clinic hours. In this case, vaccine hesitancy was not the primary driver for not getting vaccinated; instead, it was simple logistics.

We also emphasize that Case Managers use a respectful and non-judgmental approach in conversations with our beneficiaries. Everyone has a different stance on vaccinations, and our job is to listen to our members, respect their personal beliefs, and meet their needs in the best way that we can. Sometimes this means connecting beneficiaries to a trusted physician or advocate to discuss the benefits of vaccinations. Other times, this means understanding the individual is not interested in receiving a COVID-19 vaccination, and shifting the conversation to other areas of their health where we can provide assistance. This allows us to maintain positive relationships with our beneficiaries and provides greater opportunity to learn what services and supports our members need, and how we can best serve them.

  • Leverage relationships with community partners to increase connections with members. Gateway Health worked hand-in-hand with many community partners to provide and promote access to the COVID-19 vaccine. We worked with physicians, faith leaders, and influential community members (including players from the Pittsburgh Steelers) to post testimonials on social media promoting the benefits of getting vaccinated. We found these testimonials particularly impactful when the message and messenger are relatable to racial and ethnic minority groups. We also partnered with paramedic companies to offer in-home vaccinations to individuals who wanted to receive the vaccine but could not readily leave their home. Once vaccination eligibility expanded to include people 12 years and older, we partnered with local community-based organizations to conduct outreach at youth events such as summer camps and sporting games. Our core team, comprised of clinical management, community engagement specialists, pharmacists, physicians, and project managers, meets weekly to stay informed of upcoming vaccination events hosted by our partners. This ensures we can provide our members with the most up-to-date information and connect them with convenient and timely vaccination events.
  • Proactive outreach driven by data analytics and member feedback. Our member database has been incredibly useful for conducting targeted outreach during the pandemic. Initially, we conducted direct telephonic outreach to members aged 65 and older. As the eligibility criteria for vaccinations broadened, so did our outreach methods. We adopted an automated outbound call campaign called Proactive Outbound Messenger, which contacted all our members telephonically. Using an automated service allowed us to complete a high volume of outbound calls; if a member answered the automated call, they were then immediately connected to a live person to discuss the vaccine. Based on these discussions, we internally track which members have received first and second dose vaccinations, and which members indicated they do not want to receive the vaccine. We also track racial and ethnic disparities in our vaccination rates and use this data to conduct more targeted outreach to underserved zip codes. Finally, we recently administered a telephonic survey to all our members to collect feedback on our vaccination outreach program to assess what went well and what we can improve in future campaigns. Results from the survey indicate that some members still have a lack of trust in the vaccine and a lack of willingness to get vaccinated. As a result, we adjusted our focus to more community-based events where we can provide the vaccine and respond to individuals’ questions and concerns in person.

We recommend health plans think outside of the box and work creatively with your community partners to connect with your beneficiaries. It is important to meet individuals where they are. If they are hesitant about the vaccine, connect them to a trusted member of the community who can speak with them about their concerns, or direct them to tools and resources that can help inform their decision. If they have decided they do not want the vaccine, it is important to respect that decision and offer help in other areas of their health where they might need assistance. If they are interested in getting vaccinated but need support getting to a clinic or pharmacy, reach out to your community network and ask for support. In the end, health plans should remember to develop trust with your members and create opportunities for them to achieve their best health.

Topic Areas:
Resource: