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White House Must Accelerate Vaccinations of Dual-Eligible Individuals

Among the hardest hit by COVID-19 is a population of more than 12 million people who are dually eligible for Medicare and Medicaid, individuals who struggled with complex needs and fragmented care systems before the pandemic. The federal government must find ways to quickly and effectively make vaccines available to dual-eligible beneficiaries.

President Joe Biden and Vice President Kamala Harris meet with governors and mayors, including Gov. Andrew Cuomo (D-NY), Gov. Asa Hutchinson (R-AR), Gov. Michelle Lujan Grisham (D-NM) and Gov. Larry Hogan (R-MD), in the Oval Office in Washington, D.C., on Friday, Feb. 12 to discuss the vital need to pass the American Rescue Plan, which will get more support to their communities and those on the front lines of the fight against COVID-19. (Pete Marovich-Pool/Getty Images)

In a letter to the White House COVID-19 Response Team, we are encouraging President Joe Biden’s administration to take critically important steps to engage the stakeholder community to assist with getting dual-eligible individuals vaccinated — a population that has been identified as three times more likely than Medicare-only beneficiaries to be hospitalized with COVID-19.

There are about 12 million dual-eligible individuals across the United States — a heterogeneous population whose complex care needs have been exacerbated by fragmented care systems. Because they are served by Medicare and Medicaid, they must navigate a complicated web of providers and systems administered by two separate programs, leading to disproportionately high spending but poor outcomes, even before the pandemic.

The federal government and many states have taken steps to improve this fragmentation, using managed care entities to help with coordination. As we ramp up vaccination efforts, these stakeholders can be leveraged to assist with the vaccination efforts and help address special considerations must be made for those who have complex health needs and face the highest risks for infections, hospitalizations and deaths from COVID-19.

We recommend the following steps:

  1. The highest-risk populations must be targeted for vaccination, including communities of color and people with multiple chronic conditions — populations that are disproportionately represented among dual-eligible beneficiaries. To best reach these individuals, the government should coordinate with those who serve dual-eligible individuals (state agencies, insurers, and providers) and develop a plan to vaccinate people who are home-bound.
  2. Health plans that serve dual-eligible individuals should be given access to federal vaccination data to ensure that their beneficiaries are receiving both doses in a timely fashion.
  3. Clear and consistent communication must be provided to health plans and providers who care for dual-eligible individuals to facilitate education about the vaccines and overcome vaccine hesitancy.

Read the full letter below.

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