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Radar On Market Access: MCO Messaging Plays Key Role in COVID Vaccine Rollout

Posted by Lauren Flynn Kelly on Dec 24, 2020

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States and the federal government recently began rolling out the COVID-19 vaccine to health care workers across the country. Health plans, particularly those that serve high-risk individuals, may be ideally situated to coordinate care and update members on vaccination opportunities, experts tell AIS Health.

The FDA on Dec. 11 authorized emergency use of the COVID-19 vaccine made by Pfizer Inc. and BioNTech in individuals age 16 and older. Then the agency on Dec. 18 authorized Moderna’s vaccine for emergency use in people 18 years or older.

Health care workers and nursing home residents have been designated by the Centers for Disease Control and Prevention as the first group (phase 1a) to receive the vaccine.

"I think the paradigm of changing tires on a moving bus applies to this venture," remarks Margaret Murray, CEO of the Association for Community Affiliated Plans (ACAP). "We certainly support the idea of getting the vaccine to front-line health care workers and the very most vulnerable populations, such as nursing home residents, first. So CDC is off to a good start."

But ACAP, which is composed of 77 not-for-profit safety net health plans covering Medicaid, marketplace and MA enrollees, is concerned about other vulnerable seniors — such as those who are very frail or homebound and likely dual eligible — who are not part of that first round. "We need to think about them in the next wave," Murray tells AIS Health via email. "We also need to consider how most equitably to distribute the vaccine."

"Hopefully, this will start to evolve quickly, but there’s yet a lot to be figured out," concurs Cheryl Phillips, M.D., president and CEO of the SNP Alliance, pointing out that there is no mechanism for tracking who has and who hasn't received the vaccine. The plans that are most likely to serve some of the high-risk older adults that will soon qualify for the vaccine are MA Special Needs Plans, she says, "and they can be a wonderful partner for data sharing and working with providers," as well as communicating with members to help them get the vaccine.

Murray adds messaging from plans will be crucial, especially if members are skeptical of the vaccine or behind on their vaccines in general.


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Topics: Industry Trends, Market Access, Product Release, Payer