California spent millions to boost COVID-19 vaccination rates of Medi-Cal members — but they lag even more
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To boost COVID-19 vaccination rates among California’s low-income residents, last year the state launched a $350 million incentive program. But since then, the gap between those Medi-Cal members and the general population has actually grown wider.
While 84% of all Californians 5 years and older have received at least one dose of the COVID-19 vaccine, only about 57% of those in Medi-Cal, the health insurance program for low-income residents, have done so as of April, according to the latest vaccination update from the California Department of Health Care Services.
That’s a gap of 27 percentage points, and it’s slightly bigger than the gap recorded last summer.
In September, the state rolled out a six-month incentive program for Medi-Cal health plans to boost Covid vaccination rates among their 14 million members. CalMatters compared those health plans’ most recently published vaccination rates to what they looked like in August of 2021, before the start of the incentive program, to see how much each plan’s vaccination rates had grown in that time. This comparison looks at the 12 and over age group because vaccines for younger children were not available last summer.
Between last August and this April, the most improved Medi-Cal plan, CalViva in Fresno, Kings and Madera counties, went from 42% to 54% vaccinated members ages 12 and over. The plan with the lowest gains, United Healthcare Community Plan in San Diego County, went from 46% to 48%. Five Medi-Cal plans still have Covid vaccination rates under 50% — although that’s an improvement from last summer, when 11 plans were under the half mark.
The fact that rates are trending up is a good thing, but the growing gap between Medi-Cal members and the general population is concerning, said Kiran Savage-Sangwan, executive director at the California Pan-Ethnic Health Network. “They’re not making the type of progress that one would hope for,” she said. “I think it’s possible that health plans may need to reevaluate their strategies.”
Data has persistently shown that people living in the poorest zip codes and enrolled in the Medi-Cal program are vaccinated at lower rates, leaving them more susceptible to serious disease from an infection. People who are not vaccinated are 8.6 times more likely to be hospitalized than those who have been vaccinated and boosted, according to the state’s public health department.
Through the incentive program, the state paid Medi-Cal plans some money upfront to roll out efforts to get more of their members vaccinated. The plans would then get additional dollars if they met certain targets, such as increasing vaccination among their homebound members and among Latino and African American members, who have been vaccinated at lower rates than other racial and ethnic groups.
The incentive program has now ended, and the state’s Department of Health Care Services is still analyzing data provided by the health plans to determine whether targets were met. “Final performance and financial data for the current program will be evaluated before considering whether a follow-up future program would be helpful,” Carol Sloan, a department spokesperson, said in an email.In general, a health plan’s vaccination rate reflects that of the region it serves. For example, plans serving the Bay Area — where vaccination has typically been more popular— report higher Covid vaccination rates than those serving the San Joaquin Valley or the Inland Empire. But because vaccination rates in the valley were lower to begin with, Medi-Cal plans there saw the most growth in the six months of the state’s incentive program.
Officials at health plans interviewed for this story said that while they were already doing their own outreach to members prior to the incentive program, state dollars allowed them to ramp up those efforts and get creative.
Some plans increased the number of vaccination events — one even hired an event planner to redesign its pop-up clinics, bringing in balloon artists and bubblegum machines in hopes of attracting more people. Plans have offered Medi-Cal members gift cards and free days at a local museum in exchange for a vaccine. They’ve teamed up with celebrities on social media campaigns and partnered with local organizations like churches to set up clinics in zip codes with the lowest Covid vaccination rates. Plans also used the money to boost their efforts in combating vaccine misinformation via mailers and phone calls.