COVID-19 Vaccine Provider Incentive program

Getting vaccinated against COVID-19 is one of the best and safest ways people can protect themselves
and their families against the virus. As a participating practice in the COVID-19 Provider Vaccine
Incentive program, we recognize your hard work by offering incentives for helping patients make the
choice to become vaccinated.
Eligibility
The COVID-19 Vaccine Provider Incentive program is open to you if you are a participating Kentucky
primary care provider with an Anthem Blue Cross and Blue Shield Medicaid (Anthem) panel size of 25
or more members. All Anthem members identified as receiving COVID-19 vaccination services are
included in the methodology. Vaccine results will be determined by a COVID-19 vaccine claim or by
confirmation from the Kentucky Vaccine Registry.
The results will be calculated for two time periods:
• September 1, 2021 ̶Initial incentive payment
• December 31, 2021 ̶Final incentive payment
How you can qualify for a bonus
If your practice meets the below thresholds for vaccination with at least one dose by September 1, 2021,
you will receive the initial incentive payment based on the following rates:
• 30% Anthem members vaccinated ̶$20 bonus per vaccinated member
• 40% Anthem members vaccinated ̶$45 bonus per vaccinated member
• 50% Anthem members vaccinated ̶$70 bonus per vaccinated member
• 60% Anthem members vaccinated ̶$100 bonus per vaccinated member
• 75% Anthem members vaccinated ̶$125 bonus per vaccinated member
The final incentive payment is calculated based on members who are newly vaccinated between
September 1, 2021 and December 31, 2021 (see the Appendix for calculation examples). If your practice
meets the below thresholds for vaccination with at least one dose by December 1, 2021, you will receive
the final incentive payment based on the following rates:
• 30%Anthem members vaccinated ̶$100 bonus per newly vaccinated member
• 40% Anthem members vaccinated ̶$150 bonus per newly vaccinated member
• 50% Anthem members vaccinated ̶$175 bonus per newly vaccinated member
• 60% Anthem members vaccinated ̶$200 bonus per newly vaccinated member
• 75% Anthem members vaccinated ̶$250 bonus per newly vaccinated member

Anthem Blue Cross and Blue Shield Medicaid
COVID-19 Vaccine Provider Incentive program
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When you will receive your bonus
The first payment will be sent by electronic funds transfer or check based on the payment method used
for claim reimbursement. Please allow 7 to 10 business days to receive payment. If you have not
received it within that timeframe, reach out to a Provider Experience Consultant at
800-205-5870, option 3. The second payment will be generated on or before January 31, 2022.
Visit https://providers.anthem.com/kentucky-provider/communications/covid-19-updates for more
information about the COVID-19 Vaccine Provider Incentive program. We greatly appreciate your
partnership and look forward to working with you in the future.

Anthem Blue Cross and Blue Shield Medicaid

https://providers.anthem.com/ky
Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the
Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
AKYPEC-2982-21 October 2021

Appendix

Below are examples to help illustrate Anthem Blue Cross and Blue Shield Medicaid (Anthem)
COVID-19 Provider Incentive program payments.
Payment calculation examples
Payment thresholds
Percent of Anthem
Members Vaccinated

Initial Payment for
Existing Vaccinated (Per
Member)

Final Payment for Incremental
Vaccinated (Per Member)
30% $20 $100
40% $45 $150
50% $70 $175
60% $100 $200
75% $125 $250

Example 1 ̶ Change in threshold

September 1, 2021 December 31, 2021 Newly
Vaccinated
Members
Vaccinated Members 78 105 + 27
Total Provider Panel 250 251
Vaccination Rate 31% 42%
Initial Payment Final Payment Total

Original Members $1,560 ̶ $1,560
Incremental
Members

̶ $4,050 $4,050
Total $1,560 $4,050 $5,610
In this example, Provider A:
• Grew their vaccinated panel from 31% to 42% by adding 27 new members vaccinated between
September 1, 2021 and December 31, 2021
• Earned $1,560 initial payment for reaching the 30% threshold on September 1, 2021 ($20 x 78
vaccinated members)
• Earned $4,050 final payment for reaching the 40% threshold on December 31, 2021 ($150 x 27
newly vaccinated members)

Anthem Blue Cross and Blue Shield Medicaid
COVID-19 Vaccine Provider Incentive program
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Example 2 ̶ No change in threshold

September 1, 2021 December 31, 2021 Newly
Vaccinated
Members
Vaccinated Members 78 83 +5
Total Provider Panel 250 251
Vaccination Rate 31% 33%

Initial Payment Final Payment Total
Original Members $1,560 ̶ $1,560
Incremental
Members

̶ $500 $500
Total $1,560 $500 $2,060
In this example, Provider B:
• Grew their vaccinated panel from 31% to 33% by adding 5 new members vaccinated between
September 1, 2021 and December 31, 2021
• Earned $1,560 initial payment for reaching the 30% threshold on September 1, 2021 ($20 x 78
vaccinated members)
• Earned $500 final payment for staying in the 30% threshold on December 31, 2021 ($100 x 5
newly vaccinated members)

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