Medicaid plans offer incentives to boost vaccinations

TALLAHASSEE — As the delta variant of the coronavirus sweeps across the state and brings a record number of COVID-19 hospitalizations, managed-care plans that serve hundreds of thousands of Medicaid beneficiaries are offering incentives to get people vaccinated.

Gov. Ron DeSantis’ administration did not provide to The News Service of Florida the percentage of people in Medicaid managed-care plans who are 12 or older and are vaccinated against COVID-19.

But at least three Medicaid health maintenance organizations have started offering financial incentives to their members to get at least one vaccine dose.

The moves have come after a call by state Medicaid director Tom Wallace to increase COVID-19 vaccination rates, particularly for people age 50 or older.

In a June 18 memo to health plans, Wallace called vaccines a “critical” prevention measure.

Simply Healthcare Plans sent a memo to its Medicaid network providers in July encouraging them to advertise the incentive program to patients who they thought could be good candidates for vaccination. The plan is offering $25 gift cards to Walmart.

Marc Kaprow, chief medical officer for Simply Healthcare, told the News Service that the initiative was partly in response to the state’s efforts to have at least 50 percent of Medicaid beneficiaries who are 50 or older vaccinated.

Simply has about a 10 percent market share in part of the Medicaid program that provides long-term care. It also has a presence in part of Medicaid that serves a broader population — known as Medicaid managed medical assistance — and in HIV/AIDS specialty markets where it operates under the Clear Health Alliance moniker.

“We do better when our patients stay healthy. The vaccines create a tremendous opportunity for that to happen,” Kaprow said, adding, “We want our folks to not be in the hospital, we want our folks to do well.”

Simply Healthcare did not provide to the News Service a breakdown of its vaccination rates among Medicaid beneficiaries.

Florida Department of Health data shows that 47 percent of the state’s overall population of people ages 12 to 19 had received at least one vaccine dose as of Thursday. Rates for people ages 50 to 59 and 60 to 64 were 72 percent and 80 percent, respectively, according to a department report published Friday.

The state uses managed-care plans to oversee health services for about 3.8 million people in the Medicaid program.

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The plans are paid monthly premiums by the state to oversee care, including preventive care, for low-income, elderly and disabled people. By focusing on prevention, the plans are supposed to avoid more costly hospital care.

Community Care Plan, a Broward County-based plan, is offering access to $20 gift cards to members who are willing to receive at least one vaccine dose. Suzanne Tamargo, a spokeswoman for the plan, owned by the North and South Broward hospital districts, said about 100 people have taken advantage of the offer.

While Tamargo did not disclose vaccination rates, she said the incentives helped the health plan exceed the state’s goal of vaccinating at least 50 percent of beneficiaries age 50 or older.

Vivida Health Plan, which operates in Lee, Collier, Charlotte, Sarasota, DeSoto, Glades, Hendry, Lee and Sarasota counties, also has been providing gift cards since Aug. 5 to people willing to get vaccinated, according to its website.

Audrey Brown, chief executive officer of the industry group Florida Association of Health Plans, said gift cards are unusual but that the plans are looking at “every possible action that we can think of in order to get the Medicaid recipients vaccinated.”

While she said she did not have updated data, Brown said she had seen numbers from several weeks back that indicated several health plans had met the 50 percent mark for people 50 or older.

“It’s been an uphill battle, but incredibly important,” Brown said.

While health plans are offering incentives to their members, the state also is offering incentives to the plans to increase vaccination rates.

In the June memo, Wallace said the state would be willing to lower what are known as “liquidated damages” assessed against health plans if every plan met the 50 percent vaccination rate in the 50-plus population by Aug 31. The state levies liquidated damages against health plans when they don’t meet terms of their Medicaid contracts.

Wallace revised the policy last week, eliminating the requirement that all managed care plans meet the 50 percent threshold before reductions in liquidated damages could be triggered. Under the revised policy, any health plan that hits the 50 percent vaccination rate for people age 50 or older could qualify for lower liquidated damages.

Longtime social services lobbyist Karen Woodall said the policy is a “little screwed up.”

“It’s screwed up because it’s their job. Their job is to ensure adequate health care to their members,” Woodall said. “So they should already be focused on encouraging vaccines for their members.”

Woodall said the policy suggests that the plans have subpar vaccination rates. If they don’t, she said, the state is providing incentives to the health plans for goals they already are reaching.

By Christine Sexton, News Service of Florida

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