About one-third of eligible people enrolled in Florida Medicaid managed-care plans had gotten COVID-19 vaccinations as of early August, a participation rate that one former Medicaid director called low.
Data provided by the state Agency for Health Care Administration show that 3,219,124 people who are age 12 or older are enrolled in Medicaid managed-care plans and eligible to get vaccine shots. Of the total, 1,100,814, or 34 percent, had rolled up their sleeves and got vaccinated at least once by Aug. 9.
The News Service of Florida requested vaccination data broken out by each Medicaid managed-care plan, as well as by age and county, but the DeSantis administration did not immediately provide the information.
Data maintained by the Florida Department of Health indicate that 66 percent of the overall eligible statewide population had received at least one vaccine dose as of last week, including 47 percent of people ages 12 to 29. The majority of people enrolled in the Medicaid program are under 30.
“It (the vaccination rate of people in Medicaid managed care) is lower than you’d expect,” Justin Senior, who served as Medicaid director under former Gov. Rick Scott and now heads the Safety Net Hospital Alliance of Florida. “I would encourage them to step up their outreach and reach people. It’s a hard population to reach, I get it, but they really need to work hard.”
Audrey Brown, CEO of the Florida Association of Health Plans, said managed-care plans are doing “everything they can” to increase vaccination rates for Medicaid beneficiaries. The industry, she said, has regular meetings with the Agency for Health Care Administration to discuss vaccination rates and best practices to improve the rates.
“All the plans are doing things a little differently. Some are doing social media campaigns, some are doing gift cards. And a lot of them are doing pop-up vaccination clinics in neighborhoods and community centers and things like that so they can reach their member population,” Brown said. “We are trying to be innovative and creative wherever possible.”
At least three Medicaid managed-care plans are offering gift cards to entice unvaccinated members to get at least one shot in the arm.
Simply Healthcare Plans, which is offering $25 Walmart gift cards, 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.
Community Care Plan, a Broward County-based plan, is offering $20 gift cards to members who are willing to receive at least one vaccine dose. Suzanne Tamargo, a spokeswoman for the managed care plan that is owned by the North and South Broward hospital districts, said about 100 people have taken advantage of the offer.
And Vivida Health Plan, which operates in Lee, Collier, Charlotte, Sarasota, DeSoto, Glades, Hendry, Lee and Sarasota counties, also has provided gift cards since Aug. 5 to members willing to get vaccinated, according to its website.
Senior said low vaccination rates among Medicaid managed-care beneficiaries hasn’t translated into a higher-than-usual number of Medicaid patients being hospitalized.
“It’s just a lot of kids in Medicaid, and they aren’t showing up that much. I have heard nobody bring that pattern up to me, that’s it’s Medicaid enrollees,” Senior said, “The median (inpatient hospitalization) age is usually somewhere between 45 and 55 right now. It’s heavily concentrated among the middle-aged, which wouldn’t necessarily be a ton of Medicaid enrollees.”
To boost vaccination rates, Medicaid director Tom Wallace said the state would be willing to lower penalties — known as liquidated damages — that managed-care plans can face for failing to meet contractual commitments. Initially, Wallace said the penalties could be reduced if all plans could vaccinate half of enrollees age 50 or older by the end of August.
Wallace, who described COVID-19 vaccinations in a June memo as “a critical prevention measure to help end the COVID-19 pandemic,” revised the policy last week to give plans until the end of September to vaccinate members. The revision also eliminated the requirement that all plans meet the vaccination benchmark and instead allowed any plan that meets the 50 percent vaccination rate to lower its liquidated damages.
Wallace would allow managed-care plans to “accrue” credits based on the number of people vaccinated and their ages. Plans would accrue more credits for vaccinating enrollees who are 65 and older. They would earn the least for vaccinating the youngest eligible members.
The state contracts with Medicaid managed care plans to provide health care services to poor, elderly and disabled people. The plans are paid monthly premiums to cover the costs of care, ranging from well-child visits to hospitalizations. By focusing on prevention, the plans are supposed to avoid more costly hospital care,
Long-time social services lobbyist Karen Woodall is uneasy that the state is providing opportunities to plans to reduce liquidated damages.
“These are managed care companies,” Woodall said, “This is what they are supposed to do — manage care.”