COVID-19 information and guidance changes rapidly, especially as new variants continue to emerge. Health plans serving individuals dually eligible for Medicare and Medicaid face challenges with outreach, messaging, and staying well-informed about current safety practices. The resources below highlight available information that health plans can utilize to keep members up to date regarding emerging trends and best practices.

Information Regarding Emerging Variants

• Variants. As viruses mutate and evolve, each COVID-19 variant presents a unique set of challenges, and the way individuals respond needs to be tailored to each specific strain. The Centers for Disease Control and Prevention (CDC) offers a succinct overview regarding COVID-19 variants, including a snapshot of each variant, the science behind how viruses mutate, and how to protect from emerging strains.
• Omicron. Omicron is the most recent variant of COVID-19 at the time of this blog posting (February 2022).¹ While current reports indicate that this strain is not as likely to cause severe illness as earlier strains, transmission rates have been quite high and have threatened to overwhelm the US healthcare system, particularly in some areas. Dually eligible individuals face unique risks that make them more susceptible to severe illness, including complex health needs, chronic conditions, unmet social needs, and barriers to obtaining COVID-19 vaccinations.² The CDC provides a synopsis specific to Omicron that highlights Omicron’s spread, severity, and treatment updates.

Testing Updates

• Free home tests. As of January 2022, the Federal Government will ship four rapid COVID-19 tests per household to anyone who registers via https://www.covidtests.gov. While this represents a large step towards eliminating access barriers by making COVID-19 tests free and more readily available to individuals, the dually eligible population faces additional limitations.³ For example, some dually eligible individuals are experiencing homelessness, thereby presenting challenges with delivery and access, given the need for a physical address to receive these tests. See our previous blog post regarding vaccinating members experiencing homelessness for more information about this specific population.
• Who should test. Even when testing is readily available, there is often confusion surrounding when to take a test, where to access one, and what to do if the test is positive. People are turning to already overburdened emergency departments for rapid COVID-19 testing, placing additional strain on the system.⁴ The CDC provides clear guidance surrounding testing.

Prevention

• Masks. The CDC offers specific mask guidance, including information on selecting the correct mask, proper mask care and when to dispose of masks after use, mask use for children and individuals with disability, and clear guidance on when mask use is necessary.
• Boosters. Guidance surrounding booster shots continues to confuse many beneficiaries. The CDC provides a clear and easy to understand table regarding booster eligibility and when booster vaccines should be administered.
• Incentives. Health plans may encounter beneficiary questions regarding incentives offered by organizations and companies to entice individuals to get their COVID-19 vaccines. The Office of the Inspector General (OIG) offers guidance regarding incentives that health plans serving Medicare beneficiaries may reference as they consider incentivizing vaccines for members. Health plans can refer to this resource to ensure compliance prior to providing incentives for COVID-19 vaccinations for Medicare beneficiaries.
• General strategies. Although much has changed and new evidence has emerged since the beginning of the pandemic, many of the basic tenets about preventing COVID-19 still remain true for emerging variants.
  • Various blog posts on the Resources for Integrated Care website provide updated information about prevention strategies as evidence emerges.
  • In addition, this CDC website offers a clear and concise one stop shop with information on how to protect against COVID-19.

[1] Information regarding COVID-19 changes rapidly, and this post is intended to provide a non-exhaustive snapshot of key resources that health plans serving dually eligible individuals can utilize when messaging to members. For the latest information regarding COVID-19 trends and variants, refer to https://www.cdc.gov/coronavirus/2019-ncov/index.html.

[2] Centers for Medicare and Medicaid Services. (2021). Opportunities to maximize COVID-19 vaccinations among dually eligible individuals. Retrieved from: https://www.cms.gov/files/document/covid-dual-eligible-vaccine-hpms-memo.pdf.

[3] Centers for Medicare and Medicaid Services. (2021). Retrieved from https://www.cms.gov/files/document/covid-dual-eligible-vaccine-hpms-memo.pdf.

[4] The Washington Post. (2021). Hospitals, already under strain from covid cases, discourage ER visits for coronavirus tests. Retrieved from: https://www.washingtonpost.com/dc-md-va/2021/12/30/tests-er-covid-shortage/.