Health Plan Users

Monthly CAIR2 Usage Reports (URs)

Health Plans can receive monthly usage reports (URs) on contracted provider data submission activity by submitting a list of contracted provider CAIR2 IDs to CAIR2.  Email your list to Steve.Nickell@cdph.ca.gov and he will return to you a monthly report of doses submitted for each CAIR2 ID.  Learn more about the CAIR2 Usage Reports.    For Health Plans unable to obtain CAIR2 IDs, see a Method below for determining whether your contracted provider are participating by analysis of your HEDIS patient match reports.

HEDIS Patient Match Reports

Health plans (HPs), independent practice associations (IPAs), and medical groups (MPs) can submit member lists to CAIR and receive back matched patient immunization histories to help them complete their HEDIS (Healthcare Effectiveness Data and Information Set) measures.

Complete the forms below to enroll in the HEDIS process and format and submit your files according to the HEDIS Patient Match Specifications document below.  Representatives of these groups can also be given read-only access to CAIR that allows individual patient lookup.   To request a CAIR read-only user accounts, contact Steve Nickell (steve.nickell@cdph.ca.gov).  If you are interested in  patient match reports from CAIR San Joaquin or CAIR San Diego, contact the Local User Support Contact in those regions.

Using HEDIS Patient Match Reports to Determine Whether Contracted Provider Are Participating

While the preferred method for monitoring contracted provider CAIR2 participation  is through the usage reports, health plans can also monitor provider activity using the HEDIS patient match reports.  As noted below, for each patient dose exported in the HEDIS file, there is an associated CAIR2 ID.   Thus through association of each child to a contracted provider, the health plan can determine both the provider’s CAIR2 ID and whether that provider is participating.  As shown in the HEDIS Results  example below, since Patient A has a number of doses submitted by CAIR2 ID ‘10ACMEPEDS’, it’s likely that that child’s contracted provider is participating in CAIR2 and uses the CAIR ID ‘10ACMEPEDS’.  In contrast, the contracted providers who cares for Patients B, C, and D, are not to participating in CAIR2, as their patients either fail to match a patient record in CAIR2 or if they do,  no or very few doses are returned.

Patient Vaccine Dose Admin Date CAIR2 ID
Patient A DTaP 1/1/2017 19ACMEPEDS
Patient A Hep B 1/1/2017 19ACMEPEDS
Patient A MMR 3/1/2018 19ACMEPEDS
Patient A Var 3/1/2018 19ACMEPEDS
Patient A PCV13 1/1/2017 19ACMEPEDS
Patient A Rota 1/1/2017 19ACMEPEDS
Patient B No Data No Data No Data
Patient C No Data No Data No Data
Patient D No Data No Data No Data

New CAIR2 Health Plan User Role –   Coming in 2019!

In 2019, CAIR2 may allow HPs to run their own patient match/HEDIS queries.  As we develop this new user role, we will be asking for feedback from health plans.  Look for an invitation to the California Immunization Coalition Registry Committee meeting to provide input.

When the health plan user role is launched, HPs will need to sign and submit the new CAIR2 Health Plan Data Sharing Agreement (see below).  HP users will also need to be trained to use the interface.  In preparation, please review the new CAIR2 Health Plan Flat File Specification document below that contains instructions on how the files will need to be formatted.