Auto-assignment of providers in Medicaid Managed Care and factors influencing seasonal flu vaccine uptake: a retrospective analysis

ABSTRACT

Objectives: Over 50 million people in the USA are enrolled in a Medicaid Managed Care plan. If they do not select a primary care provider, they are auto-assigned to one. The impact of auto-assignment has largely been understudied outside the context of patient satisfaction with the insurance plan. The purpose of the study was to explore the association between auto-assignment and flu vaccination use, which will contribute to our understanding of factors influencing the COVID-19 vaccine uptake. Methods: Retrospective data from the Enterprise Data Warehouse of a health system were obtained for adult Medicaid enrolees assigned to a Midwestern health system in 2019. Descriptive statistics, independent t-tests and tetrachoric correlations were used to explore the relationship between auto-assignment and flu vaccine receipt among a large sample of Illinois residents (N = 7224). The sample was then divided into those who chose their provider (n = 6027) and those who were auto-assigned (n = 1197). Key findings: Individuals who selected their provider were deemed to have flu vaccine coverage over those who were auto-assigned (33.2% vs. 6.6%). Furthermore, among those who were auto-assigned, age, number of office visits and having chronic morbidities, including chronic obstructive pulmonary disease (P < 0.01), diabetes (P < 0.01) and heart failure (P < 0.01), were positively associated with flu vaccine receipt. Conclusions: Individuals who are auto-assigned to a primary care provider are less likely to be flu vaccine recipients than those who choose their provider. This suggests that auto-assignment is a risk factor that influences vaccine receipt. This research provides perspectives for outreach efforts that target individuals who are auto-assigned to a provider.