Provider Newsletter | Issue 22

COVID-19 vaccine incentives for providers, pharmacists and members

As announced in the Sept. 22 provider newsletter, the Alliance is now offering both member and provider incentives for COVID-19 vaccination efforts. Below, you will find a summary of incentives for providers, pharmacists and members. Please note that these incentives apply to COVID-19 vaccination rates for Medi-Cal members only.

Vaccine incentives for providers

Providers have three different ways to earn incentives, and may earn from all three of the following:

1. MyCAvax or HRSA enrollment incentive. Provider offices must be enrolled in myCAvax or the Health Resources and Services Administration (HRSA) in order to get doses of the COVID-19 vaccine to distribute to patients. To encourage enrollment, the Alliance is offering primary care providers a $10,000 one-time incentive to enroll in myCAvax or HRSA on or after Sept. 1, 2021.
   To be eligible for this incentive, providers must submit evidence of enrollment in myCAvax or HRSA by emailing [email protected]. Please only submit evidence of enrollment if you have enrolled in the specified time period (on or after Sept. 1, 2021). Note: providers can only receive this incentive payment once for either myCAvax or HRSA enrollment per office.To enroll in myCAvax, please visit the myCAvax website and complete the six-step enrollment process. Once your staff has completed the required training, you will be able to start the enrollment process.

   Federally qualified health centers are eligible to receive the COVID-19 vaccine through the Health Resources and Services Administration (HRSA). For more information, visit HRSA’s webpage, COVID-19 Information for Health Centers and Partners.

   Q: Who can I contact about enrolling in the California COVID-19 Vaccination Program?
   A: If you have questions about enrolling in the California COVID-19 Vaccination Program, email [email protected] or call 833-502-1245, Monday through Friday from 8 a.m. to 6 p.m.

2. $25 per member vaccination. For every member age 12 and over who receives their first dose of a COVID-19 vaccination, the provider administering the vaccine will receive a $25 incentive payment.Note: This incentive is based on Alliance members who receive their first COVID-19 vaccine dose between Sept. 1, 2021 and Feb. 28, 2022.Payments will be calculated and paid no later than the end of the second quarter of 2022 (for vaccines administered between September and December 2021) and again no later than the third quarter of 2022 (for vaccines administered between January and February 2022).

   Providers will need to submit rosters of vaccinated members to the Alliance to be eligible for the incentive payment. More information will be forthcoming about how to submit vaccination rosters to the Alliance.

3. Performance-based vaccination incentive
   The vaccination rates for members 12 years and older will be calculated by clinic group.
   Note: This incentive is based on Alliance members who receive their first COVID-19 vaccine dose between Sept. 1, 2021 and Feb. 28, 2022.
   • When a PCP office reaches 70% of eligible members vaccinated, a $25 incentive will be paid per member who received their first vaccine dose during the measurement period.
   • When a PCP office reaches 85% of eligible members vaccinated, a $45 incentive will be paid per member who received their first vaccine dose during the measurement period.

   There are two measurement periods: Sept. 1-Dec. 31, 2021 and Jan. 1- Feb. 28, 2022. The PCP incentive is paid one time for each goal met.

   Q: Where will I be able to see my linked membership list?
   You can see your linked member list in the “Reports” section of the Provider Portal.

   Q: Will the Alliance let me know which of my assigned members have received the first dose of the COVID-19 vaccine?
   A: There is a COVID-19 vaccine report in the Provider Portal that is updated weekly with vaccination data from multiple sources. Please reconcile the report against your records before contacting members to schedule COVID-19 vaccinations.

   Q: Does a member need to receive the COVID-19 vaccine at my office for this incentive to be paid?
   A: No, we will credit the PCP for vaccinations administered at any site, provided we’ve received the data.

   Q: How will I know what percentage of linked members have received at least one dose?
   A: Refer to the COVID-19 vaccination rate in the Provider Portal. If it’s easier, you can export the report into Microsoft Excel. Then, sum the number of members with at least one dose of the COVID-19 vaccine. Divide this number by the total eligible in the report.

   Q: When will we receive the payout for this incentive?
   A: Payments for the fee-for-service and performance-based incentive will be made no later than the end of the second quarter of 2022 for September-December 2021 performance and no later than the end of the third quarter of 2022 for January-February 2022 performance. The Alliance will track and calculate the percentage of linked members with one or more doses of the vaccine, so providers are not required to submit this data to receive the incentive payment.

Vaccine incentives for pharmacists

In addition to being reimbursed for the vaccine, pharmacists will be paid $25 per vaccine dose administered. Incentive calculations will occur no later than the end of the second quarter of 2022 for vaccinations delivered between September and December. Payments will be made no later than the end of the third quarter of 2022.

Pharmacists will need to submit rosters of vaccinated members to the Alliance to be eligible for the incentive payment. More information will be forthcoming about how to submit vaccination rosters to the Alliance.

Questions?

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.