It is important for health plans that serve the dually eligible population to work to close the COVID-19 vaccine gap across all demographics.¹

• Approximately 62 percent of individuals dually eligible for Medicare and Medicaid are over the age of 65. Adults over the age of 65 with disability are less likely to have received one or more doses of the COVID-19 vaccine compared to their peers without a disability (90 percent versus 95.1 percent.²
• Approximately 48 percent of dually eligible beneficiaries are of a racial or ethnic minority group. Vaccination rates by race and ethnicity vary greatly. As of March 9, 2022, the Asian Non-Hispanic population had the highest proportion of fully vaccinated individuals (60.1 percent) while the Black Non-Hispanic population had the lowest proportion of fully vaccinated individuals (41.0 percent).³
• The Centers for Disease Control and Prevention (CDC) recommends that individuals who are moderately or severely immunocompromised receive a total of four doses of the COVID-19 vaccine.⁴

Health plans serving dually eligible beneficiaries continue to play a vital role in improving the vaccination rate among their members. The California Department of Health Care Services (DHCS) required Medicaid health plans to outline their specific vaccine response plan to close the vaccination gap among members. Below are examples of promising practices from the vaccine response plans.⁵ The full compilation of promising practices can be found here.

Partner with Community-Based Organizations (CBOs):

Community partners and providers play a key role in the multifaceted approaches many health plans have taken to increase vaccination rates. CBOs that members already trust and interact with on a regular basis provided insight into the concerns that individuals had around vaccinations, which allowed health plans to tailor strategies that address individual concerns or access barriers. Promising practices for health plans to improve vaccination rates through community partnerships include:

• Partnering with CBOs (e.g., places of worship, community centers, local grocery stores) that focus on serving historically underserved populations to host vaccination events, find available COVID-19 vaccine appointments, and educate the staff on how to address vaccine concerns with accurate medical information.
• Partnering with Aging and Disability Resource Centers, Area Agencies on Aging, and other organizations that primarily serve individuals with disability or older adults, to conduct outreach and provide needed services to members and their aging caregivers.
• Conducting live events on social media with celebrities, social influencers, vaccine ambassadors, and physicians to combat misinformation and build trust.
• Collaborating with CBOs to identify potential locations for vaccine pop-up sites that are fully accessible for individuals with disability in COVID-19 hotspots.
• Encouraging their network of community partners to share upcoming community events for vaccination promotion through their communication channels.
• Collaborating with CBOs and local agencies to provide gift card incentives for members receiving a vaccination.
• Collaborating with community partners to host pop-up clinics or expanding their own clinic hours (e.g., Kaiser Permanente) to allow for after business hours vaccinations.

Partner with Providers:

Providers also play a critical role in combating misinformation and administering vaccines. Promising practices for health plans to improve vaccination rates through partnerships with providers include:

• Providing onboarding support for providers to administer vaccines, including sharing educational tools and communication resources to help improve vaccine confidence.
• Incentivizing providers to vaccinate unvaccinated members through various strategies, including tiered incentives.
• Encouraging local physicians of color to speak at pop-up clinics in communities with low vaccination rates to talk about vaccine efficacy and safety.
• Ensuring provider webpages are up-to-date and contain relevant information and guidance about the COVID-19 public health emergency.
• Surveying network providers to understand what resources and support they need to successfully serve members during the pandemic.

Delivery of Trustworthy Outreach and Communication:

An earlier blog post highlighted strategies for health plans to use data to identify unvaccinated members and prioritize outreach. Health plans will need to continue to remain a trustworthy information source and build trust with vaccine hesitant members. Additionally, continued outreach and communication with all members is vital to help members stay updated on the COVID-19 public health emergency and vaccination recommendations. Promising practices for health plans to improve vaccination rates through outreach and communication include:

• Disseminating marketing and communication materials featuring ethnically and culturally diverse individuals that provides evidence-based information and addresses perceived risks and misconceptions.
• Facilitating physician “office hours” at specific sites, such as affordable housing and community centers, for members to ask questions and hear from physicians.
• Utilizing new and existing bus shelter signs that specifically promote how to find a vaccine location.
• Creating a member facing COVID-19 information page in multiple languages, including links to additional community and mental health resources and information combating COVID-19 vaccination misinformation and myths.
• Providing assistance via phone to schedule COVID-19 vaccine appointments for members with limited computer literacy, and at-risk members.

[1] CMS Medicare-Medicaid Coordination Office. (2020). Data Analysis Brief: Medicare-Medicaid Dual Enrollment from 2006 through 2019. Retrieved from https://www.cms.gov/files/document/medicaremedicaiddualenrollmenteverenrolledtrendsdatabrief.pdf.

[2] Centers for Disease Control and Prevention. (2022). COVID-19 Vaccination Among People with Disabilities. Retrieved from https://covid.cdc.gov/covid-data-tracker/#vaccinations-disability-status.

[3] Centers for Disease Control and Prevention. (2022) Take Care: Covid Data Tracker Weekly Review. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html.

[4] Centers for Disease Control and Prevention. (2022) COVID-19 Vaccines for Moderately or Severely Immunocompromised People. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/past-reports/02182022.html.

[5] California Department of Health Care Services. (2021). Improving COVID-19 Vaccination: A Compilation of Resources. Retrieved from https://www.dhcs.ca.gov/Documents/COVID-19/COVID-19-Vaccine-Promising-Practices.pdf.