The influenza season is off to an early start and more severe than a year ago. The CDC reported widespread flu activity in seven states, regional activity in 18 states and local activity in another 18 states as of Dec. 2 and a higher-than-baseline percentage of outpatient visits for flu-like illness. CDC said it is tough to predict when influenza activity will peak for the current season, but stresses it will increase in the coming weeks. Against this backdrop, initial health plan data on the costs of flu-related doctor visits, emergency department visits and hospitalizations are hard to come by, as is information on preventative measures since plan members are getting vaccinated in a wide variety of places, including health fairs, pharmacies and clinics.

Spokesperson Sunny Yu of Molina Healthcare Inc. said Dec. 14 that CDC reports show high influenza activity in South Carolina, and moderate influenza activity in Texas and Puerto Rico. All other Molina states show minimal activity, she said.

“Molina monitors influenza through our internal prescription data. To date, there do not appear to be any unusual patterns,” Yu told AIS Health. But, she added, “South Carolina has seen an increase in hospital admissions due to respiratory conditions, which is consistent with increased influenza activity [and] Texas has anecdotal reports of increased utilization.”

Yu explained that it is too early to assess vaccination rates or emergency room utilization as these are based on claims data.

L.A. Care Health Plan — the largest publicly operated health plan in the country, serving more than 2 million members in Los Angeles County — tells AIS Health that it expects a boost in the number of flu-vaccinated members this season, as has occurred over the past few years. And L.A. Care has ramped up its member outreach efforts to encourage vaccinations.

In a Q&A, Katrina Miller, M.D., L.A. Care’s chief medical information executive, explained the situation as of Dec. 12:

AIS Health: Is there a lot of flu in California now?

Miller: The flu is always a concern this time of year and is a risk to children, older adults or those who have weak immune systems. We see a lot of flu cases each year during this time. There are indications that flu activity is increasing across the state. In fact, Kaiser Permanente facilities in Northern California reported a 4.6 percent increase in hospitalizations due to influenza and pneumonia last week [i.e., the week of Dec. 4], compared to the week before. Here in Los Angeles County, 7.7 percent of respiratory samples were positive for flu among those tested at hospitals last week. Over the last five seasons, the average was 2 percent for the same week in each year.

AIS Health: How is L.A. Care preparing for what by all accounts is a worse flu season than last year with a less effective vaccine?

Miller: L.A. Care is providing the flu vaccination to our members with several options to choose from. A member can get it from their PCP [primary care physician], or can go directly to the pharmacy and get flu vaccination. There is no authorization or approval process required. A member can get it directly without any delay. The effectiveness of the flu vaccination varies because it consists of the strain of flu experience in previous years. If there is a new strain, it might not be effective. But L.A. Care also provides other treatments for those who develop the flu, such as antiviral medications and treatments for conditions often caused by the flu, such as pneumonia.

AIS Health: Are your members getting vaccinated?

Miller: L.A. Care has seen an increase in those obtaining flu vaccinations each of the last few years and expects to continue to increase the number of members getting vaccinated this year, as well.

AIS Health: Has your health plan’s influenza strategy evolved over the years in terms of outreach to members, etc.?

Miller: To align with the start of the 2017-2018 flu season and the availability of the influenza vaccine, L.A. Care conducts an annual “Fight the Flu” campaign for all lines of business. Information [about flu shots] is included in the fall editions of the member newsletter, and providers are also educated on the importance of the flu vaccine in the fall edition of [their] newsletter. CMC [Cal MediConnect] members [who are dually eligible for Medicare and Medicaid] are sent a flu prevention packet that contains information on how to prevent the flu, the importance of getting a flu vaccine, and how to get the vaccine through their primary care provider’s office or network pharmacy. All health plan members receive an automated flu shot reminder phone call, and the calls are tailored to emphasize the increased risk of flu complications for seniors and people with disabilities. In addition, L.A. Care covered members also receive an emailed flu shot reminder.

Find CDC’s weekly FluView report at