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How to Leverage the Medicare Program for a COVID-19 Vaccination Campaign

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Although the Medicare program is primarily an insurance program, it serves additional functions by virtue of its population-wide coverage (individuals older than 65 years, as well as people who are blind or disabled or who have end-stage kidney disease) and its vast and comprehensive data on beneficiary health care utilization and costs, clinical conditions, and medication use.

Medicare data have been used to examine process and outcomes of care and prevalence of chronic conditions of public health importance, and for infectious disease surveillance, such as influenza, and disease-related outcomes, such as hospitalization and death. Data on Medicare beneficiaries have also been used in disaster preparedness and response to identify individuals who require access to electricity (such as those receiving ventilator support) and, while maintaining privacy protections, to notify public health agencies of their names and addresses in anticipation of and during disasters such as hurricanes, wildfires, and other disaster-related power outages.1

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Article Information

Corresponding Author: Nicole Lurie, MD, MSPH, Coalition for Epidemic Preparedness Innovations (CEPI), 1900 Pennsylvania Ave NW, Washington, DC 20006 (nicole.lurie@cepi.net).

Published Online: November 19, 2020. doi:10.1001/jama.2020.22720

Conflict of Interest Disclosures: Dr Lurie reported formerly serving as assistant secretary for preparedness and response at the Department of Health and Human Services, where some of the ideas discussed in this article were initially developed. Dr Experton reported that funding for the development of the predictive model for severe COVID-19 cited in the article was provided by the Johns Hopkins University Applied Physics Laboratory under a prime contract with the Department of Defense Joint Artificial Intelligence Center.

Disclaimer: The views expressed in this article do not necessarily represent those of the Coalition for Epidemic Preparedness Innovations or Harvard Medical School.

References
1.
Department of Health and Human Services. HHS emPOWER Program fact sheet. Updated March 30, 2020. Accessed November 12, 2020. https://empowermap.hhs.gov/HHS%20emPOWER%20Program_Fact%20Sheet_FINAL_v9_508.pdf
2.
Salmon  DA , Akhtar  A , Mergler  MJ ,  et al; H1N1 Working Group of Federal Immunization Safety Task Force.  Immunization-safety monitoring systems for the 2009 H1N1 monovalent influenza vaccination program.   Pediatrics. 2011;127(suppl 1):S78-S86. doi:10.1542/peds.2010-1722LPubMedGoogle ScholarCrossref
3.
DeSalvo  K , Lurie  N , Finne  K ,  et al.  Using Medicare data to identify individuals who are electricity dependent to improve disaster preparedness and response.   Am J Public Health. 2014;104(7):1160-1164. doi:10.2105/AJPH.2014.302009PubMedGoogle ScholarCrossref
4.
National Academies of Sciences, Engineering, and Medicine. National Academies release framework for equitable allocation of a COVID-19 vaccine for adoption by HHS, state, tribal, local, and territorial authorities. Published October 2, 2020. Accessed November 12, 2020. https://www.nationalacademies.org/news/2020/10/national-academies-release-framework-for-equitable-allocation-of-a-covid-19-vaccine-for-adoption-by-hhs-state-tribal-local-and-territorial-authorities
5.
Experton  B , Tetteh  H , Lurie  N ,  et al. A multi-factor risk model for severe Covid-19 for vaccine prioritization and monitoring based on a 15 million Medicare cohort. medRxiv. Preprint posted November 3, 2020. doi:10.1101/2020.10.28.20219816
6.
Salmon  D , Yih  WK , Lee  G ,  et al; PRISM Program Group.  Success of program linking data sources to monitor H1N1 vaccine safety points to potential for even broader safety surveillance.   Health Aff (Millwood). 2012;31(11):2518-2527. doi:10.1377/hlthaff.2012.0104PubMedGoogle ScholarCrossref
7.
Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): older adults. Updated September 11, 2020. Accessed November 12, 2020. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html
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