Featured Research

from universities, journals, and other organizations

Medicaid reimbursement and childhood flu vaccination rates linked

Date:
October 18, 2010
Source:
University of Rochester Medical Center
Summary:
Increasing the amount that physicians are reimbursed by Medicaid for administering influenza shots may raise vaccination rates among poor children, according to a new study.

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 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."

Additional co-authors of the study include Megumi Kasajima and Andrea Berry, both the URMC Department of Community and Preventive Medicine. The study was funded by the National Institute of Allergy and Infectious Disease.


Story Source:

The above story is based on materials provided by University of Rochester Medical Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Byung-Kwang Yoo, Andrea Berry, Megumi Kasajima, and Peter G. Szilagyi. Association Between Medicaid Reimbursement and Child Influenza Vaccination Rates. Pediatrics, 2010; DOI: 10.1542/peds.2009-3514

Cite This Page:

University of Rochester Medical Center. "Medicaid reimbursement and childhood flu vaccination rates linked." ScienceDaily. ScienceDaily, 18 October 2010. <www.sciencedaily.com/releases/2010/10/101018074030.htm>.
University of Rochester Medical Center. (2010, October 18). Medicaid reimbursement and childhood flu vaccination rates linked. ScienceDaily. Retrieved July 24, 2014 from www.sciencedaily.com/releases/2010/10/101018074030.htm
University of Rochester Medical Center. "Medicaid reimbursement and childhood flu vaccination rates linked." ScienceDaily. www.sciencedaily.com/releases/2010/10/101018074030.htm (accessed July 24, 2014).

Share This




More Health & Medicine News

Thursday, July 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Condemned Man's US Execution Takes Nearly Two Hours

Condemned Man's US Execution Takes Nearly Two Hours

AFP (July 24, 2014) America's death penalty debate raged Thursday after it took nearly two hours for Arizona to execute a prisoner who lost a Supreme Court battle challenging the experimental lethal drug cocktail. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com
China's Ageing Millions Look Forward to Bleak Future

China's Ageing Millions Look Forward to Bleak Future

AFP (July 24, 2014) China's elderly population is expanding so quickly that children struggle to look after them, pushing them to do something unexpected in Chinese society- move their parents into a nursing home. Duration: 02:07 Video provided by AFP
Powered by NewsLook.com
Hundreds in Virginia Turn out for a Free Clinic to Manage Health

Hundreds in Virginia Turn out for a Free Clinic to Manage Health

AFP (July 24, 2014) America may be the world’s richest country, but in terms of healthcare, the World Health Organisation ranks it 37th - prompting hundreds in Virginia to turn out for a free clinic run by “Remote Area Medical”. Duration 02:40 Video provided by AFP
Powered by NewsLook.com
Idaho Boy Helps Brother With Disabilities Complete Triathlon

Idaho Boy Helps Brother With Disabilities Complete Triathlon

Newsy (July 23, 2014) An 8-year-old boy helped his younger brother, who has a rare genetic condition that's confined him to a wheelchair, finish a triathlon. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins