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 is participating by analyzing your HEDIS patient match reports.

HEDIS Patient Match Reports (revised 12/11/2019)

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.  Note: To assist HPs, several new fields have been added to the HEDIS report.  More info

Note to HEDIS Requestors about File Size (3/13/2020) It has come to our attention that many HPs are sending very large files containing multiple name variants for the same member.  While we understand the rationale for doing this is to increase the  probability of matching member patients in CAIR2, it is also causing the HEDIS matching process to take much longer as larger files take more time to process.  We are therefore asking HPs who submit member files with multiple variant names to take steps to reduce their input file size in subsequent HEDIS requests by eliminating all non-matching variants member names when a member is successfully matched.  Reducing file sizes will benefit everyone as HPs will get their reports more quickly.   Also, beginning 3/16/2020, CAIR2 will no longer process patient input files with >1M rows to reduce overall processing time.  PDF

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 ‘19ACMEPEDS’, it’s likely that that child’s contracted provider is participating in CAIR2 and uses the CAIR ID ‘19ACMEPEDS’.  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.

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