NJ targets Medicaid members in vaccination campaign

Credit: (Michael Mancuso, NJ.com)
State Health Commissioner Judy Persichilli has pushed for better access to COVID-19 vaccines for vulnerable and disadvantaged populations.

State officials have taken proactive steps to support nearly 1.9 million New Jersey Medicaid members during the pandemic, including a recent initiative to expand COVID-19 vaccination that involves phone calls to nearly 260,000 people most at risk of infection.

Much of the work – which also involved mailings in English and Spanish, ongoing case management, and partnerships with medical and social service providers to ensure members receive proper care, as well as supportive care. food and other necessities – is carried out by a handful of health insurance companies that provide Medicaid coverage under contracts with the State Department of Human Services.

As demand for COVID-19 vaccines outstripped supply for months – which has sparked general public frustration over the lack of access to vaccines – which has changed recently and the number of daily vaccines is now rising. decline, raising concerns about the effect of vaccine hesitancy. State officials are actively working to overcome this trend in their campaign to vaccinate 4.7 million New Jersey adults by July.

“We have worked closely with the five managed care organizations that administer our state Medicaid program on vaccine deployment, particularly on how best to deploy some of our state’s health equity strategies,” he said. Acting DHS Commissioner Sarah Adelman told members of the Senate. Budget and Supply Committee Tuesday in response to a question from Senator Troy Singleton (D-Burlington).

The committee discussed the department’s $ 7.29 billion spending plan as part of its ongoing review of Gov. Phil Murphy’s budget proposal for the coming year. DHS has set aside more than $ 50 million over two years to help pay for the administration of the COVID-19 vaccination in Medicaid patients, officials said. The federal government is currently covering the cost of the shots themselves.

Adelman said DHS has also worked with insurance companies “on a more granular level” to review medical histories to identify those who were most at risk for COVID-19. The scan revealed hundreds of thousands of Medicaid members with chronic illnesses or with daily assistance needs who indicated they should be prioritized for immunization, she said. These groups were targeted for phone calls.

“When this sensitization was made, in many cases, it included help to register for a vaccine, a warm transfer to the direct line of the Ministry of Health (making appointments for vaccines) and if the person needed help getting to their vaccine appointment, (insurance) plans can help as well, ”Adelman said.

The five Medicaid plans – managed by Horizon Blue Cross Blue Shield, UnitedHealthcare, Amerigroup, Aetna and WellCare – have also been asked to collect data every two weeks to help the state track immunization progress and identify investments. additional required. But the numbers are often delayed and incomplete, according to DHS program officials, who declined to share the numbers on Tuesday.

Lobbying for vaccine equity

While the outcome of this investment is not yet clear, the need for greater equity in vaccines has been evident for months. Murphy and Health Commissioner Judy Persichilli have consistently emphasized the need to improve interest in and access to COVID-19 vaccines among minority groups, low-income residents and others most at risk of infection. .

The administration has partnered with churches and other community organizations, held virtual town halls, and expanded its advertising and other public awareness activities to increase equity in vaccines. But black and Hispanic individuals are still vaccinated at a slower rate than their white counterparts, according to state figures.

Efforts to immunize frail seniors in nursing homes and other long-term care – a process overseen by the federal government, not the state – started slowly but were largely successful, with at least 85% of residents nursing homes now vaccinated. Many of these residents are covered by Medicaid.

But DHS has identified an additional 1.2 million Medicaid members who live in the community and were eligible for the vaccine early on based on their pre-existing conditions. This group includes more than 583,000 members aged 65 and over who suffer from a number of chronic health conditions; nearly 260,000 of these people are considered a priority because of their previous diagnoses or the fact that they live alone. This group is at the center of “high touch” awareness led by insurance plans, officials said.

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At the onset of the pandemic, insurance plans sought to ensure that at-risk Medicaid members had access to health services and daily assistance as needed, program officials said. As the epidemic escalated, this evolved to help those infected with COVID-19, track positive case numbers and coordinate hospital discharges.

Finally, the focus was on vaccines, with bilingual mailings at the end of February to highlight the reasons for getting vaccinated – such as the protection it can offer other family members – and information on how and where to register for a vaccine. Direct phone calls were added later for people in the most at-risk categories.

The approach of a company

Horizon Blue Cross Blue Shield – the state’s largest insurance provider, with some 960,000 Medicaid members, of which nearly 134,000 are considered most at risk – has deployed its existing care managers to make calls and a been removed from a pool of over 500 nurses. and social workers elsewhere in the company to intervene, according to Wendy Morriarty, vice president of the company and general manager of Medicaid.

“In a crisis, we have these troops available,” she said. “But everything was on the bridge.”

Thanks to the relationships Horizon has already established with its healthcare providers, including community clinics and other local organizations like churches, Morriarty said the company has also been able to conduct more direct outreach activities. in person in some neighborhoods. Through these partnerships, community health fairs become opportunities to connect people with a health care plan, food assistance and access to vaccines. “We have this group literally mobilized on the streets,” she said.

Like the other plans, Horizon also brought in internal “data assistants” to help remove information from the state vaccine database, claim forms and federal sources, Morriarty said. But the shortcomings of these systems leave them with an incomplete picture of who gets vaccinated. The company also tracks vaccine uptake and denials through its appeals, she said, and all of those numbers are compiled into massive and complex spreadsheets that it shares with DHS.

What the data shows is that “we’re not nearly done,” Morriarity said. “The next big hurdle for us, for this population, is the people who just don’t want to leave their homes,” she added. They may not be technically confined to their homes, but they may have limited mobility or be afraid of getting sick.

“How can we make it easier for them to get the vaccine to them?” This is the next step, ”said Morriarty.

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