Medicaid Managed Care Is Vital to Expanding Vaccination Access

August is National Immunization Awareness Month, and the Modern Medicaid Alliance is highlighting the critical role that Medicaid plays in covering and encouraging vaccines.

Medicaid ensures that millions of low-income children, people with disabilities, older Americans, and hardworking adults have access to lifesaving vaccines that prevent and fight disease. Through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, children under 21 enrolled in Medicaid receive all vaccines recommended by the Centers for Disease Control and Prevention. Additionally, the Vaccines for Children Program provides vaccines at no cost for children under 18 enrolled in Medicaid, uninsured, underinsured, or who are American Indian or Alaska Native. Most state Medicaid agencies across the country also cover some adult immunizations, including influenza and pneumococcal vaccines.

Medicaid coverage of routine immunizations protects millions of Americans – especially the most vulnerable communities – from serious illness such as the flu. The flu vaccine can reduce the risk of a flu-related ICU admission by 74% for children and 82% for adults.

Medicaid Managed Care Is Shaping the Vaccine Landscape

As a vital foundation of the Medicaid program, Medicaid managed care plays a major role in enhancing the program’s vaccination coverage. Medicaid managed care plans serve over two-thirds of all Medicaid beneficiaries, and in 36 states, managed care organizations cover 75% or more of all children enrolled in Medicaid. As the principal way Medicaid delivers care to enrollees, managed care plans, in support of the Vaccines for Children Program, allow millions of children across the country to receive the essential immunizations they need.

Managed care also provides an important opportunity to improve vaccination coverage and performance. As our nation continues to work to combat COVID-19, Medicaid managed care organizations are already taking steps to encourage vaccination among their members and the most vulnerable communities, in particular.

Medicaid Managed Care’s Contributions to the COVID-19 Vaccination Campaign

The COVID-19 crisis has underscored the critical role that Medicaid plays in expanding access to vaccines for vulnerable and underserved communities. Medicaid and Medicaid managed care plans cover COVID-19 vaccines and have stepped up to slow the spread of the disease by offering providers technical assistance and educating patients to encourage vaccination. Some notable actions include:

  • Centene partnered with the Pro Football Hall of Fame to showcase football pros encouraging people to get COVID-19 vaccinations and addressing vaccine hesitancy through a series of public service announcements.
  • UPMC Community HealthChoices teamed up with two other Medicaid managed care organizations, the Pennsylvania Department of Human Services, and Rite Aid pharmacies to set up COVID-19 vaccination clinics for vulnerable individuals across Pennsylvania.
  • COVID-19 AmeriHealth Caritas collaborated with state, community, and provider partners to expand access to COVID-19 vaccines for adolescent Medicaid members ages 12 and older with their parent’s or guardian’s consent. The aim is to help ensure this young population receives the second vaccine by Aug. 16, 2021, so they are able to return to school in September fully vaccinated.

From providing comprehensive vaccine coverage to working creatively with partners to address COVID-19 vaccine hesitancy, Medicaid and Medicaid managed care organizations are keeping Americans healthy and safe. For more information about actions by Medicaid managed care plans to improve COVID-19 vaccine acceptance and access, click here.