Imagine this. You're at the Swiss Hotel in
Chicago surrounded by top executives from leading insurance
companies and health
systems. Welcome to Becker's fall Parishes Roundtable,
November 4th through 6, 2020
4. Picture the excitement as you gather business
cards from over 500 executive level attendees,
building invaluable connections.
Feel the energy as you participate in over
26 educational sessions led by 90 elite speakers.
Envision yourself engaging in lively discussions about new
health plans, hospital at home models, behavioral health,
and price transparency.
Now imagine being inspired by keynotes from boxing
legend, Sugar Ray Leonard, and 4 time NBA
All Star, Chris Webber. Their stories will leave
you motivated and ready to innovate.
Don't miss out on this unique opportunity. Get
registered today. Visit beckershospital
events page. See See you in
Chicago.
Hello, everyone. This is Jacob Emerson with the
Becker's Payer Issues podcast.
Thrilled today to be joined by 2 special
guests. Doctor. Joanna Vadalfalan is the chief medical
officer of Quality and Pediatrics at UPMC Health
Plan. And Rebecca Nagel is the director of
Medicaid and CHIP Quality Programs
also at UPMC Health Plan.
Thank you both so much for taking the
time to join us on the podcast today.
Thank you so much for having us.
So I'd love to hear a little bit
more about you both. If we could talk
about professional backgrounds
and what it is that you both are
doing today at UPMC Health Plan. Doctor Vadafalan,
I'll go to you first.
Thank you so much, Jacob.
I am the chief medical officer, as you
just said, of quality and pediatrics. A lot
of the work I do is across different
lines of business here at the health plan,
collaborating in really with that focus of clinical
quality improvement.
I'm also a clinical assistant professor of pediatrics.
And in that opportunity, I work as a
pediatrician,
still on a part time basis seeing patients
and in collaboration also with the University of
Pittsburgh School of Medicine.
Fantastic. And, Rebecca, how about you?
Hi, Jacob. Thanks. I'm a registered nurse by
background.
I joined UPMC Health Plan about 2 years
ago as the director of Medicaid and CHIP
Quality.
Prior to that, I was with the National
Managed Care Organization,
and I'm a certified professional in health care
quality.
Wonderful. Well, like I said, we really appreciate
you both taking the time to sit down
with us and share your insights
on what is a very important topic today.
So Joanna, I want to come to you
first to get your perspective
as a pediatrician,
and to dive into the topic of vaccines
and really vaccine hesitancy.
To
to to zoom out a bit more, Joanna,
can you talk a little bit about the
main reasons you're seeing today on why parents
and caregivers
might be hesitant
about vaccines and how you as a caregiver
are approaching conversations with with young patients and
and their parents who might have these concerns.
Well, thank you so much, Jacob, for asking
that question.
As a pediatrician in clinical practice, I directly
interact with parents and caregivers as part of
routine well child care and adolescent care. Unfortunately,
in Unfortunately, my over 20 years of experience,
I have seen an increase in mistrust and
misinformation
that
negatively impact families' belief about the importance and
safety of immunizations.
Many young families search for medical information
online and on social media platforms that are
not evidence based or from experienced
medical professionals.
It is important to me as a pediatrician
and a provider to encourage open communication to
answer parents' questions.
I highly welcome dialogue from parents.
But a challenge arises when families have already
made up their minds about immunizations
without allowing for a caring and trained medical
professional like a pediatrician
to offer advice and rationale.
I am the first one to recognize that
making medical decisions on behalf of of your
child can be very scary, which is why
I I believe in the importance of having
a medical home for your family.
A medical home provides families with a safe
place to ask questions and make decisions
with the support and the input of a
physician or a provider who knows your child
and family and is trained to provide the
best evidence based recommendations.
My personal approach to patients and families to
always take a step back and to listen.
Motivational interviewing is a crucial skill that helps
me as a doctor to address hesitancy
and mistrust
effectively,
meeting my patients and families where they are.
I also share with many of my patients
and I'm also a mom of 2 sons
that are fully immunized.
And I will never subject my children to
harmful things because I love them tremendously
and I will never recommend a medical treatment
that I will not consider for my own
children.
So in other words, I treat my patients
with the same advice I give my own
family.
This experience has weighed and helped me build
trust with many families,
that I have served throughout the year, especially
those from vulnerable backgrounds.
I also
patients,
especially the preteens,
as part of the process. It's important to
explain to patients why patients are important,
not just to the parent or caregiver.
So let patients understand why vaccination or immunization
is important
and how it helps protect them and keep
them in school
and doing the activities they enjoy,
you increase collaboration
and update.
So remember, today's patients are tomorrow's parents who
will be making decisions about their children's immunizations.
And if they have a positive experience and
understand early on why immunizations
are so important, you're more likely to have
their buy in when they are older.
Absolutely. It's really great advice, Joanna. And it's
interesting that you're seeing,
vaccine hesitancy
increase, especially among with the widespread use of
social media today.
Rebecca, how would you say that UPMC as
an enterprise is advocating for the importance of
vaccines and really backing up what Joanna just
talked about. And ultimately on the ground, what
work is taking place to increase
local vaccination rates within within your communities and
within the markets that you serve?
Thanks for that question, Jacob. That's such an
important question,
because increasing local vaccination rates and advocating for
the importance of vaccines is so critical in
the current climate.
We are seeing the impacts of vaccine hesitancy
on everything that we do. And since 2020,
we've seen year over year decreases in our
national quality benchmarks for routine pediatric immunizations,
and these declines span various populations like commercial,
Medicaid, and CHIP membership.
This trend's concerning and it's that's not only
from a quality measure perspective, but also due
to the larger potential impacts these decreasing
vaccination rates can have on public health and
cost of care.
UPMC Health then advocates for the importance of
vaccines and actively works to increase vaccination rates,
and we do this through a variety of
initiatives.
And we provide education and awareness campaigns to
inform the community about the importance of vaccines.
This includes things like sharing accurate information about
vaccine safety, efficacy, and the benefits of immunizations,
and we do this in a variety of
ways that include things like marketing campaigns,
our children's health website,
member and provider newsletter articles, and educational tables
at community events.
Events would include things like the mom Mommy
and Me Baby Expo that was sponsored by
UPMC Magee Women's Hospital.
The goal of that event was to connect
pregnant women with education and resources,
and the health plan had a table staffed
by physicians and one one was a pediatrician
to provide expectant parents and families
education about the importance of WellCare and immunizations.
Last year, we had a pediatric collaborative call
series and one of those featured a webinar
for providers on how to address vaccine
hesitancy
and offered provider CMEs for attending.
We also have our pediatric case management team
that outreaches members with gaps in care for
preventative services. These would include things like well
child visits and immunizations to provide education, assist
with appointment scheduling, and connect members to a
medical home if needed.
And then the health plan works to assure
that vaccines are readily available to the members
in the communities where they live. This would
include offering vaccines at convenient locations, such our
u p such as our UPMC facilities, provider
offices, and community events.
Last year, we partnered with the UPMC Neighborhood
Center to offer flu vaccines at some events.
And I'll just let you know that the
UPMC Neighborhood Center offers an array of services
to our plan members as well as individuals
and families in the surrounding community.
These include things like social service referrals,
virtual health care services, and workforce development programs.
UPMC Health Plan also engages with health care
providers to emphasize the importance of vaccines,
and we wanna encourage them to discuss vaccinations
with their patients.
We wanna support our providers, and we do
this in a variety of ways. 1 is
through value based arrangements that are tied to
key quality metrics, such as well child visits
and immunizations.
And we can also support them with resources
when that's needed. Last year, we worked to
create educational materials around immunizations that were requested
by our providers.
It was a tear off sheet that could
be shared with members to reinforce education that
was given during the well child visit around
things like immunizations.
And we also have practice based care managers
embedded in many of our provider locations. These
practice based care managers can help connect families
with gaps in that have gaps in care
for things like well child visits and immunizations
to their assigned medical home.
Wow. So, clearly, UPMC is doing a lot
to address this concerning trend and and some
of the numbers that you both are seeing.
Rebecca, for other health plan executives that are
listening in right now all over the country,
How would what would you advise them in
terms of how their organization can better advocate
for the importance of vaccinations
among among their members?
And any other new or creative ways,
that you would recommend to incentivize vaccinations,
to really move that needle on the ground?
Sure.
Health care providers are valuable partners, and they
play a crucial role in reducing vaccine hesitancy.
So I would say that organizations should encourage
their providers to have open and proactive discussions
with patients about the importance of vaccines.
Organizations should support providers and assure providers have
resources they need to effectively educate these vaccine
hesitant families.
And health care organizations should really strive to
make vaccines easily accessible to members and patients.
This would include things like offering vaccines at
multiple locations, maybe extended hours that are convenient
for parents,
walk in appointments and online scheduling options.
Implementing vaccine reminder and recall systems can also
help providers ensure that they're not missing or
overlooking certain immunizations.
And UPMC for you, our Medicaid line of
business, currently offers members and member incentives for
completing well child visits, which would encourage members
to connect with their providers and have those
important discussions about vaccinations.
Joanna, anything else you would add there in
terms of best advice for health plan leaders
listening in?
Yes. I I really appreciate that question because
I believe that everybody, including health and a
second, could play a crucial role in education.
I believe that repetition and consistent messaging on
why immunizations are so important
will help us all. For example, are your
patient and member facing teams equipped with the
right information that they can share with your
customers when they call your organization?
Do they know where to direct patients and
members for immunizations,
especially this coming fall when we expect many
questions related to the, flu and COVID 19
immunizations.
Does your website and patient facing materials include
community friendly resources available in several
languages to reach the diverse population you serve.
For for your many community facing teams, partnering
with local organizations
are very important.
If you work with a local school or
a church, how can you support the connection
to keep them promoting immunizations?
It might be as simple as partnering with
a local pharmacy to host a flu clinic
or having a pharmacist talk to a faith
based organization
about the importance of influenza immunizations.
I personally believe in the importance of partnering
with local organizations that have already built trust
and are seen as leaders in their communities.
Aligning this message is very powerful in overcoming
vaccine misinformation
and many of the information that, potentially our
patients or members may encounter online.
So some really fantastic advice from you both.
So, Joanna, before we go, any other final
thoughts or tidbits
you wanna offer our re our listeners that
we were not able to get to?
Yeah. I think there's there's no single solution,
no, to addressing vaccine hesitancy.
It is a multifactorial
problem.
It will take a to continue improving our
community immunization rates. And all of these efforts
are very important and very well worth it.
Fantastic. Well, Joanna, Rebecca,
so appreciate you both taking the time out
of your days to share your insights with
us and our listeners.
Which really appreciate it. And for our listeners,
if you'd like to listen to more podcasts
from Becker's Healthcare, you can visit beckershospitalreview.com.