06/24/2021

Medicaid Managed Care Plans Increase Payment for COVID Vaccine

A Note from the
Ohio Association of Health Plans:

June 18, 2021

Recently, Gov. Mike DeWine laid down the challenge to all of Ohio’s Medicaid Managed Care Plans: Get more Medicaid members vaccinated. The gap between the vaccination rate of the general public and that of Medicaid recipients as of May 24 was unacceptable: 45% of Ohioans overall vs. just 24% of Medicaid members.

Even though the vaccine is free to everyone, our Medicaid members face other barriers such as lack of transportation, inflexible work schedules and no ability to make appointments online. Having more Ohioans vaccinated is the key to returning to a pre-pandemic normal, so we’re working with our partner providers and pharmacists to wipe out those barriers, one by one.

Providers offering on-the-spot vaccinations to patients who are in their offices for other reasons is very effective, but we heard from you that many providers can’t meet the necessary patient volume and also use valuable office space to observe the patients for 15 minutes as CDC guidelines dictate. It also is a challenge to adjust providers’ workflows to administer the vaccines. Our solution: Through Aug. 15, we’ll pay providers $100 per vaccination instead of the standard $38.

That should make it possible for providers to accommodate the extra work as well as the lower patient volume made necessary by the waiting period.

A working group consisting of representatives from Aetna, Buckeye Health Plan, CareSource, Molina Healthcare, Paramount Advantage and UnitedHealthcare meets regularly to iron out the details and logistics of this and other expanded vaccination efforts.

Of course, we couldn’t be successful without the work of our health care partners: the physicians who are altering their operations to offer those shots; the nurses who are staffing the many public vaccination events we’re planning; and the pharmacists who are making their stores another vaccination opportunity.

All of us in health care have important roles to play in spreading the vaccine and stopping the virus. We’re proud to harness the creativity and commitment of the health plans to meeting this unique challenge.