Dr. Takashi Wada, chief medical officer for the Inland Empire Health Plan, which serves 1.5 million people in Riverside and San Bernardino counties, said a key part of his vaccination strategy was to pass along incentive dollars to the health providers with whom they contracted. “Because we really wanted our providers to talk to their patients about the importance of the vaccine…and administer the vaccine themselves,” he said.
The percentage of plan providers administering the vaccines in their offices, rather than referring, rose from 40% to 60% during the six months of the incentive program, Wada said.
Yet despite continued efforts and an improvement of about 8 percentage points since August, less than half of Inland Empire Health members aged 12 and older have received an injection.
“There are still absolutely opportunities (for growth), and that’s why we’ve worked so hard to find ways to try to make the vaccine more accessible and gain trust,” Wada said.
Early in the vaccine distribution process, access was often cited as the main challenge – supplies were scarce, especially in rural or more remote areas of the state. Now health plans are hearing a lot more about hesitation due to mistrust, misinformation and political ideology, Wada said.
Jake Hall, assistant director of vendor contracts at Kern Health Systems, which covers about 330,000 people in Kern County, said a common reason members give for declining the vaccine is that they’ve had a COVID-19 infection. Pregnancy is also another common reason, Hall said. Centers for Disease Control and Prevention officials recommend vaccination for pregnant women and for those who have had an infection in the past.
Officials of health plans with higher Covid vaccination rates have said one of their focus points now is to increase vaccination among young children. As of mid-April, 28% of California children ages 5 to 11 enrolled in Medi-Cal had received at least one dose, according to Medi-Cal data. In comparison, 40% of all children in this age group statewide had received an injection.
“I think in our community there has been a lot of support to get children vaccinated, but a mandate is missing. It makes it difficult,” said Christine Tomcala, executive director of Santa Clara Health Plan.
Last month, state lawmakers withdrew a bill that would have required children to be vaccinated to attend school. On the same day, the Newsom administration also postponed its proposed vaccination mandate for schoolchildren until at least July 2023.
In the coming months, health insurance plans will also face shifting enrollment numbers as California expands Medi-Cal to undocumented people ages 50 and older, adding new people who may not still be vaccinated.
Additionally, during the declared federal public health emergency COVID-19, the state has suspended efforts to verify eligibility for Medi-Cal. Assuming the emergency declaration ends as planned this summer, it is estimated that approximately 2 million people will lose their Medi-Cal coverage if they are no longer eligible for the program, either because their income has increased or because have had access to other types of health coverage in the past two years.
“We’re adding people who might not be vaccinated, but we might also lose people who are, so it might feel like we’re slipping back,” Tomcala said.
Update: A table in this story has been corrected to indicate that Blue Shield of California’s Promise Health Plan does not cover Medi-Cal patients in Alameda County.
CalMatters COVID and Healthcare Coverage is supported by grants from the Blue Shield of California Foundation, California Health Care Foundation, and California Wellness Foundation.
