Learning Objectives for this Presentation:
By the end of the presentation participants will be able to: 1) Understand how Managed Care Organizations (MCOS) or other payer groups can help with private provider recruitment. 2) Discuss potential incentive options.


Background:
The inability to recruit private providers to contribute data to registries has been a long-standing problem. Without mandated reporting, many providers refuse participation. Payer groups receive immunization data from claim statements. Using registries to find additional immunization data rather than costly, manual, onsite audit of patient records has resulted in improved HEDIS scores.


Setting:
Indiana Immunization Registry (CHIRP), Medicaid Risk-based MCOs and private provider offices.


Population:
Risk-based Medicaid Managed Care recipients and their medical providers.


Project Description:
MCOs are moving towards a Pay for Performance model to meet/exceed immunization coverage rates. The Risk-based MCOs in Indiana informed physicians that participating in CHIRP would improve their immunization coverage rate. The MCO and CHIRP partnered to identify the largest non-participating providers, examined what recruitment effort had already occurred and how the MCO could assist in recruitment. Medicaid physician relations staff were registry-trained so they could demonstrate the application and enroll providers in CHIRP. For some key offices, Medicaid covered all or some of the cost of the electronic export to include them in CHIRP.


Results/Lessons Learned:
Monetary reward draws the private provider's attention like few other incentives can. State registries have little opportunity to provide incentives to providers. Collaborating with a managed care provider who has a vested interest in improving HEDIS scores brings benefit to both parties. Managed Care Organizations can use their contractual relationship with providers and their monetary incentives to highlight the value of registries and how they can help providers reach the MCO goals.