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Provider Newsletter | Issue 20

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COVID-19 Vaccine Incentives for Primary Care Providers

The Department of Health Care Services (DHCS) has announced incentive opportunities for health plans to support members and providers in increasing COVID-19 vaccination rates. The first milestone that DHCS expects health plans to achieve is a 5% increase in COVID-19 vaccination rates by October 31, 2021. We need your help!

In response to this opportunity, the Alliance will be offering both member and provider incentives for COVID-19 vaccination efforts, for services beginning in September 2021. While the specific details of the provider incentive are still being developed and will be communicated in more detail in the coming weeks, we want to share the following high-level information:

  • CalVax Enrollment Incentive: one-time payment for enrollment in CalVax to administer COVID-19 vaccinations.
  • Per Member Vaccine Incentive: fee for service payment for each member who receives a COVID-19 vaccination (payment to be made to the primary care organization to whom the member is assigned at the time of vaccination).
  • Panel-Based Vaccination Incentive: payment based on the total percentage of a primary care provider’s assigned panel who is vaccinated.
  • Potential/Under Consideration  One-Time Vaccination Support Incentive: one-time payment from the Alliance to support COVID-19 vaccination efforts, including outreach events, temporary staffing, and supplies.

In order to maximize these incentive opportunities, the Alliance encourages our Primary Care Providers to continue and enhance efforts to increase COVID-19 vaccination rates for Alliance members. If you have questions or would like additional support to engage members in receiving a COVID-19 vaccination, please contact our Provider Services team at 800-700-3874 ext. 5504.

Flu shot season + new member incentive

The flu can lead to hospitalization and, in some cases, death. To protect the health of our communities, it is critical for providers to communicate to patients just how important the flu shot is for both children and adults—especially as we continue to navigate the effects of the pandemic.

During peak flu season, the Alliance is encouraging members six months and older to get a flu shot.

Flu shots are available at no cost for Alliance members and their families. All members can get the flu shot by visiting their doctor. Members age 19 years and older also have the option to get their shot at a local pharmacy. Members between 6 months and 8 years old may need two doses of the flu shot.

The Alliance is committed to getting flu shot information to members through various channels, including:

To help you maximize flu shot uptake among your patients, we’ve created the following resources:

  • A new member Wellness Reward focused on increasing flu shot rates among toddlers. Children ages 7 to 24 months who complete both flu shot doses between September and May will be entered into a monthly raffle for a $100 Target gift card. See the Health and Wellness Rewards section of our Care-Based Incentive Summary page for details.

When patients come in to get the flu vaccine, it’s also a great opportunity to encourage anyone over the age of 12 to get the COVID-19 vaccine. The flu shot and the COVID-19 vaccine can be given at the same time. For more information and answers to patient FAQs regarding seasonal flu and COVID-19, visit the CDC website.

Members will soon have health info at their fingertips

Coming soon, Alliance members can access their health information through the smartphone or desktop application of their choice. Through the app, they will be able to review information about past visits to Alliance providers, such as prescribed medications, lab results, immunization records and more.

We have shared this information with members in the member newsletter and on our website’s Access Your Health Information page. Please refer members who have questions to this page for the latest details. Our Member Services representatives are also ready to answer questions from members who call in about this topic.