Navigation Links
Medicaid reimbursement and childhood flu vaccination rates linked
Date:10/17/2010

Increasing the amount that physicians are reimbursed by Medicaid for administering influenza shots may raise vaccination rates among poor children. That is the conclusion of a study published online today in the journal Pediatrics.

The study, conducted by a team of researchers at the University of Rochester Medical Center (URMC), analyzes state-by-state vaccination data over three flu seasons and contends that the number of poor children receiving the annual flu shot could be increased by up to one percentage point for every additional dollar provided to doctors to administer the vaccine.

"There is a strong correlation between flu vaccination and Medicaid reimbursement rates," said Byung-Kwang Yoo, M.D., Ph.D., an assistant professor in the Department of Community and Preventive Medicine at URMC and the lead author of the study. "Improving reimbursement rates could improve vaccine coverage among poor children."

The study looked at data from the National Immunization Survey (NIS) for the 2005-2006, 2006-2007, and 2007-2008 flu seasons. The survey, which is sponsored by the Centers for Disease Control and Prevention (CDC), compiles detailed information including socio-economic data such as the family's income level, number of children, ethnicity, and mother's education level and marital status on childhood immunization rates.

The authors looked at immunization rates for children between the ages of 6 and 23 months. The CDC first recommended that children in this age group receive the annual flu vaccine in 2004. Using the NIS data they were able to determine the vaccination rates in each state by family income level.

The income threshold for Medicaid eligibility varies by state, so the study compared rates for children at or below the federal poverty $22,000 or less for a family of four a population that is universally covered by state Medicaid programs. Children in families below the federal poverty level have the lowest vaccination rates.

The authors then compared the vaccination rates in each state with the amount of money physicians are reimbursed by Medicaid for administering the vaccine. In 1993, the U.S. Congress created the Vaccines for Children program which covers the actual cost of flu vaccine for Medicaid-eligible children. However, doctor's offices still incur costs for administering the vaccine (e.g. overhead, nurses and staff time, etc.)

Medicaid reimbursement rates for services are determined on a state-by-state basis and, in the case of vaccine administration, are widely divergent. Reimbursement rates during the period studied ranged from $2 in Colorado, Connecticut, and Hawaii to almost $18 in New York. The average reimbursement was $9. In a previous study, Yoo and his colleagues calculated that the actual cost to doctor's offices for administering vaccines was $20.

"In most states the reimbursement from Medicaid is far below the actual cost," said Yoo. "The may create an obvious disincentive when physician's offices lose money every time they give a flu shot, even though vaccines are provided for free."

Their analysis showed that states with lower Medicaid reimbursement rates had lower vaccination rates. Using mathematic models, the authors were then able to calculate the impact on vaccination rates if Medicaid reimbursement rates were increased. They found that for every extra dollar in reimbursement, vaccination rates could increase by between 0.6 and 0.9 percentage points. Meaning a $10 increase in reimbursement could raise vaccination rates by up to 10 percentage points among low income children.

While it is clear that raising reimbursement rates come at a cost, the authors point out that there is a significant financial burden associated with the treatment of flu. Among U.S. children under the age of 5 years it is estimated that the annual cost associated with hospitalization as a result of influenza is upwards of $163 million. The annual cost burden of emergency room visits is estimated to be as high as $279 million.

"The more children with access to seasonal flu vaccinations, the lower the overall burden will be on our health care system from the costs associated with treating influenza," said URMC pediatrician Peter Szilagyi, M.D, M.P.H., a co-author of the study. "This study demonstrates that we can remove one of the barriers to higher vaccination rates among poor children by more closely aligning reimbursement with cost."


'/>"/>

Contact: Mark Michaud
mark_michaud@urmc.rochester.edu
585-273-4790
University of Rochester Medical Center
Source:Eurekalert

Related medicine news :

1. Kaiser Analysis Finds Record Medicaid Enrollment Growth in 2009
2. NGA Focus on States Health Care Responsibilities Spotlights Need for Congress to Pass Federal Medicaid Relief
3. Congressional Staff Briefing, Wed., Feb. 24 on Mental Health, Medicaid & Block Grants
4. U.S. Senate Urgently Needs to Extend Medicaid Match in Economic Recovery Legislation
5. Patient Advocates From Across Virginia Visit the State Capitol to Address State Budget Cuts to Medicaid
6. Create new federal center to spur Medicare and Medicaid innovation
7. Proposed Medicaid Cuts Threatens Health Care Access for 400,000 Maryland Children
8. New York State Adopts Universal Provider Datasource to Reduce Administrative Costs for Medicaid
9. Experts support new federal center for Medicare and Medicaid innovation
10. SDI Reports: Emergency Room Visits Covered by Medicaid Increased 6% in 2009
11. ASTRO applauds nomination of Dr. Donald Berwick to head Centers for Medicare and Medicaid Services
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/23/2017)... ... , ... The Military Officers Association of America (MOAA) announced its support for ... Marine Col. Thomas G. Bowman. , Bowman currently serves as the staff director for ... the issues and challenges veterans face with the VA. Following a 30-year career of ...
(Date:6/23/2017)... ... June 23, 2017 , ... Military Connection friend ... entry to the JFK Virgin Atlantic lounge. , Bensko is no stranger to ... years ago, Bensko dedicated her life to supporting our wounded veterans. A world-class photographer, ...
(Date:6/23/2017)... ... , ... Goodcents Deli Fresh Subs today announced the opening of a new ... St. Topeka, Kan. 66604 (near 21st and Gage). It is owned and operated by ... locations in the Topeka and Bonner Springs, Kan. area. , “Goodcents has such ...
(Date:6/23/2017)... ... June 23, 2017 , ... Ensuring meat ... new videos highlight the importance of correctly using a meat thermometer. The videos ... done extensive research on consumer food safety habits. Dr. Bruhn explains the variety ...
(Date:6/23/2017)... ... ... 21 Middle East and South Asia Leaders Selected as Eisenhower Fellows , ... in 11 countries across the Middle East and South Asia to embark on a ... and ideas with the leading minds in their fields. , For the first ...
Breaking Medicine News(10 mins):
(Date:6/5/2017)... The Cincinnati location of ... (NYSE: DPLO), has been awarded a Top Workplaces 2017 ... Results are based on an employee survey administered by WorkplaceDynamics, ... improvement. The survey measures several aspects of workplace culture, including ... ...
(Date:5/30/2017)... 2017 DarioHealth Corp. (NASDAQ: DRIO), a leading global digital ... that it will be presenting at the 7th annual LD Micro ... Erez Raphael , CEO, of DarioHealth will be giving the presentation ... on June 6th & 7th, 2017 at the Luxe Sunset Bel ... micro-cap space. About LD Micro ...
(Date:5/26/2017)... May 25, 2017  In response to the opioid ... Direct Relief is working with Pfizer to make up ... no cost to community health centers, free and charitable ... "Pfizer has a long-standing commitment to ... ensuring patient safety through educational activities," said Caroline ...
Breaking Medicine Technology: