• December 6, 2021

Blue Shield Stops Overseeing California’s Vaccine Program

As public health officials continue to push to vaccinate millions of hard-to-reach Californians against COVID-19, they are doing so largely without the help of Blue Shield of California, the company whose oversight, according to Governor Gavin Newsom , was essential to improve the state’s slow dose distribution earlier this year.

The company’s reduced role announced last month closes a controversial chapter in the state’s ongoing efforts to combat COVID-19, one that began with questions about the Newsom administration’s handling of who should be first in line when supplies were limited and culminated in the governor’s surprising decision. to put the insurance giant, a longtime political donor, in charge.

Newsom said Blue Shield would speed up state distribution of life-saving vaccines and improve slow accounting for unused doses. But now, with Blue Shield taking a step back, the results of that decision remain unclear. Many of the county officials who initially criticized Blue Shield’s involvement remain skeptical of the vaccine program’s effectiveness, while others say the company improved state operations by standardizing the way vaccine providers reported doses. managed, allowing officials to more accurately assess where to send more.

“Some may want to rewrite history and say that we just need to give the existing plan more time. But we didn’t have time, ”said Sami Gallegos, spokesman for the California Department of Public Health. “The crisis needed a solution and our lives depended on us moving faster.”

County officials have questioned whether the state would move faster under Blue Shield’s $ 15 million contract since Newsom announced the change in late January. Amid objections from vaccine providers, Blue Shield and the state didn’t finalize the contracts until mid-March, when the number of doses shipped to California was increasing rapidly.

San Joaquin County Board of Supervisors Chairman Tom Patti insists that the state’s vaccine program run by Blue Shield slowed his region’s ability to receive vaccines. Patti, a Republican, said the county successfully fought for some modifications to the conditions that Blue Shield and the state insisted on as a prerequisite for receiving vaccines, but that the changes under the contract still resulted in San Joaquin having They have to scrap their own targeting program – to reach populations.

“This whole process was a hindrance and in no way helped,” Patti said. “There was no benefit in any capacity.”

Some Fresno County officials raised concerns in February about the contract, saying they were concerned it would establish an online scheduling system that could make it difficult to vaccinate farmworkers in their region.

Six months later, Joe Prado, acting deputy director of the Fresno County Department of Public Health, said in a statement that the contract with Blue Shield provided “great assets,” such as a statewide vaccine market that allowed counties to see and transfer your vaccine. inventories among other counties.

Kat DeBurgh, executive director of the Association of Health Officials. California, said it’s difficult to assess how the state’s vaccination rates would have changed, if at all, without Blue Shield. The company is taking on a limited role now, as needs around vaccines have changed, he said. When Blue Shield stepped up earlier this year, DeBurgh said the state had limited supply and high demand.

“We have a constant supply now and we are trying to make sure that demand increases,” he said.

Part of the impetus for the review under Blue Shield was the revelation that life-saving vaccines were on the shelves in some areas and the state’s flawed data system made it impossible to track how many doses were available at any given time. To counter that, the state began requiring that most providers use its My Turn appointment system, which was initially awash with complaints of glitches and compatibility issues.

DeBurgh said the My Turn system finally became very useful. Not all vaccine providers were required to use the system, alleviating some initial concerns.

“It got better over time,” he said. “It was a portal that allowed him to find out if he was eligible, make an appointment and receive the vaccine. That was very helpful. “

Blue Shield’s involvement in determining where to send doses in the state and which healthcare providers would be part of California’s new vaccine network frustrated county officials who until then had their own programs. The lack of buy-in from the counties delayed the start of the Blue Shield program, and almost all the counties initially refused to sign a contract with the insurance company that outlined the new rules to follow to receive doses from the state.

Many county officials argued that the state’s decision to outsource oversight of how vaccines were allocated starting in February came after internal issues were resolved and the biggest hurdle, a lack of supply, was fading.

California received 1.5 million doses in December and 3.4 million in January outside of federal programs that went directly to pharmacies and other providers, according to data provided by the California Department of Public Health. That increased to 4.6 million doses shipped to California in February, 5.9 million in March and 8.4 million in April at the peak.

“The problem that existed was that there were not enough vaccines,” said Santa Clara County Executive Jeff Smith. “In my opinion, what Blue Shield did was move around the loungers of the Titanic. They did not add any additional value to our response. “

Blue Shield officials said the company helped build California’s capacity to deliver 6 million doses a week, up from 1.6 million before the contract. However, that maximum capacity was largely unnecessary as the most vaccines the state received in one week was 2.4 million doses.

“It was really frustrating,” Smith said. “It took a lot of time and effort that he went out of his way to deal with the contract with [Blue Shield]. Ultimately, we improve our own vaccine supply by going directly through the federal government. “

Lucresha Renteria, executive director of Mendocino Coast Clinics, which serves 10,000 people in northern Mendocino County, said the system under Blue Shield became too “bureaucratic and cluttered,” forcing her to navigate multiple forms and sites. web to receive doses.

“The system kept changing and it was difficult to figure out how to order vaccines,” Renteria said.

Renteria said that when he ordered the vaccines, he received twice what he asked for. After a month, he said the clinic chose to order through the county public health department.

“I know the state thought they were doing this to improve it, but we only needed a few months to figure it out with our public health department,” he said. “By the time they implemented the [contract], we had already figured it out. They were solving a problem that no longer existed and the bureaucracy was creating more problems ”.

As part of the contract, the state asked Blue Shield to ensure that 95% of residents in urban areas were within 30 minutes of a vaccination site and those in rural areas were within an hour of access. to a provider. Blue Shield said they exceeded that goal, with 99% of Californians within those distances.

“Our reward has been to help save lives,” Blue Shield President Paul Markovich said in a statement.

Under Blue Shield contract, the company can bill incurred out-of-pocket expenses of up to $ 15 million and will not benefit from the deal, the company said. A spokesman for the state public health department said the company has yet to bill for any of its expenses.

Critics have argued that Blue Shield can earn more than the goodwill and expenses reimbursed under the state contract. The company routinely does business with the California government that has significant financial impacts. For example, in a state budget bill signed by Newsom last month was a long-sought wish list item for Blue Shield that requires health plans to share patient records and data through a Health Information Exchange for 2024.

Newsom’s longtime donor Blue Shield said in a press release that the company is “delighted” with the new law, which is expected to lower health care costs by allowing providers to see a more complete picture of the health history of a patient.

“Blue Shield has a lot to gain from developing a [Health Information Exchange] because it would help it compete with California’s largest health plan, Kaiser Permanente, ”said Michael Johnson, a former Blue Shield executive who has become critical of the company.

State officials say Blue Shield will continue to play an “advisory role” during the term of its contract with the state, which ends in December. That feature allows the state to increase Blue Shield’s involvement or seek the advice of company officials if a variant of COVID-19 requires the state to increase the distribution of additional doses of vaccines, according to a spokesperson for the public health department. .

The total cost to the state to create and run the vaccine network is set at $ 202 million, according to the most recent budget estimates released in May.

That’s up from the Newsom administration’s estimate in March when administration of the vaccine network was estimated to cost $ 151 million, most of which was related to information technology support. The state also hired management consulting firm McKinsey & Co. for $ 13 million from February through April to assist Blue Shield and the state with the vaccine delivery system.

Sarah Dukett, legislative advocate for California Rural County Representatives, said some areas of the state may not see a difference with Blue Shield taking a step back.

“I don’t think they did a bad job or a good job, I just don’t think it has dramatically changed priorities on the ground in rural counties,” Dukett said. “The biggest problem was always the supply, so I’m not sure of the impact [Blue Shield] I finally had. “

Leave a Reply

Your email address will not be published. Required fields are marked *