Welcome to the Resources for Integrated Care (RIC) COVID-19 Vaccination blog series where we will spotlight promising practices shared by health plans and other experts. Individuals dually eligible for Medicare and Medicaid have been disproportionately impacted by COVID-19 and likely face barriers to accessing vaccination. This blog will feature efforts by providers and health plans to connect hard-to-reach individuals with COVID-19 vaccination by addressing barriers such as complex healthcare issues, chronic conditions, and unmet social risk factors. We encourage you to frequently visit our blog series page to read about new promising practices as they emerge.
Centers for Medicare & Medicaid Services (CMS) released two new resources to support health plans and providers in their efforts to connect dually eligible individuals with COVID-19 vaccination. The COVID-19 public health emergency is disproportionately affecting dually eligible individuals, racial and ethnic minority groups, and individuals with disabilities. As of December 2020, CMS data show that COVID-19 cases and hospitalizations are three times more likely among dually eligible individuals than other Medicare beneficiaries. Dually eligible individuals with COVID -19 across demographic categories (i.e., race, age, sex, disability, and end-stage renal disease status) are hospitalized at higher rates than their Medicare-only counterparts.
1) The CMS Office of Minority Health maintains a COVID-19 and COVID-19 vaccine website (go.cms.gov/omhcovid19vaccine) that is consistently updated with Federal resources to assist those who work with the populations most vulnerable to COVID-19, including resources in for health care professionals, for consumers and patients, and in additional languages. Partners and organizations are also encouraged to download and share two From Coverage to Care (C2C) COVID-19 resources to help everyone remain healthy during this public health emergency. Access these resources and shareable graphics in 8 languages at https://www.cms.gov/about-cms/agency-information/omh/health-equity-programs/c2c/consumer-resources.
2) The CMS Medicare-Medicaid Coordination Office released a memo, “Opportunities to maximize COVID-19 vaccinations among dually eligible individuals” to remind Dual Eligible Special Needs Plans, PACE organizations, and MMPs of their unique opportunities to ensure equitable access and uptake of the COVID-19 vaccine among individuals dually eligible for Medicare and Medicaid. Across all forms of managed care, organizations that integrate Medicare and Medicaid benefits have the broadest benefit packages, strongest contractual requirements to coordinate care for enrollees, and greatest potential for developing robust approaches to COVID-19 vaccination. Maximizing this potential is an urgent priority.
- Of particular note, the memo has a section on ways to analyzedata to inform action.CMS encourages plans to use all available data sources to actively monitor the receipt of vaccines among their enrollees.[*]
- CMS strongly encourages plans to collect and use data on COVID-19 testing, hospitalizations, and outcomes stratified by gender, race, ethnicity, preferred language, disability status and other demographics.
- In January CMS made COVID-19 vaccine claims data available to plans so they can monitor which individuals received a vaccination. Plans can download vaccination information on a weekly basis.  CMS is encouraging plans to use this information to further refine their outreach efforts and analyze disparities. Please see the HPMS memo of January 7, 2021.
- In November 2020, CMS provided feedback reports to Medicare-Medicaid Plans (MMPs) in 9 states analyzing COVID-19 encounters among MMP enrollees by race, ethnicity, and sex. CMS is encouraging MMPs to review this data in conjunction with internal plan data, and other state/local data sources, to identify and address any potential disparities in COVID-19 incidence and outcomes among enrollees. CMS will update the data quarterly.
The memo also includes information on active preparation for equitable vaccination, opportunities to increase vaccination through plan benefit structures, and helpful resources to support this priority.
[*] This includes accessing the CMS data snapshot which is updated monthly as more claims are received. This data release is part of the agency’s efforts to provide data transparency during the pandemic and ensure the public has this vital information as soon as it is available. CMS anticipates releasing similar information on Medicaid beneficiaries in the future.