Mandy A Allison1, Sean T O'Leary2, Megan C Lindley3, Lori A Crane4, Laura P Hurley5, Brenda L Beaty6, Michaela Brtnikova2, Andrea Jimenez-Zambrano6, Christine Babbel6, Stephen Berman7, Allison Kempe2. 1. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora. Electronic address: mandy.allison@ucdenver.edu. 2. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora. 3. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. 4. Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora. 5. Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Division of Internal Medicine, Denver Health, Colo. 6. Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora. 7. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora.
Abstract
OBJECTIVE: Vaccines represent a significant portion of primary care practice expenses. Our objectives were to determine among pediatric (Ped) and family medicine (FM) practices: 1) relative payment for vaccine purchase and administration and estimated profit margin according to payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines because of finances. METHODS: A national survey conducted from April through September 2011 among Ped and FM practitioners in private, single-specialty practices. RESULTS: The response rate was 51% (221 of 430). Depending on payer type, 61% to 79% of practices reported that payment for vaccine purchase was at least 100% of purchase price and 34% to 74% reported that payment for vaccine administration was at least $11. Reported strategies to reduce vaccine purchase cost were online purchasing (81% Ped, 36% FM), prompt pay (78% Ped, 49% FM), and bulk order (65% Ped, 49% FM) discounts. Fewer than half of practices used strategies to increase payment; in a multivariable analysis, practices with ≥5 providers were more likely to use strategies compared with practices with fewer providers (adjusted odds ratio, 2.65; 95% confidence interval, 1.51-4.62). When asked if they had stopped purchasing vaccines because of financial concerns, 12% of Ped practices and 23% of FM practices responded 'yes,' and 24% of Ped and 26% of FM practices responded 'no, but have seriously considered.' CONCLUSIONS: Practices report variable payment for vaccination services from different payer types. Practices might benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery.
OBJECTIVE: Vaccines represent a significant portion of primary care practice expenses. Our objectives were to determine among pediatric (Ped) and family medicine (FM) practices: 1) relative payment for vaccine purchase and administration and estimated profit margin according to payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines because of finances. METHODS: A national survey conducted from April through September 2011 among Ped and FM practitioners in private, single-specialty practices. RESULTS: The response rate was 51% (221 of 430). Depending on payer type, 61% to 79% of practices reported that payment for vaccine purchase was at least 100% of purchase price and 34% to 74% reported that payment for vaccine administration was at least $11. Reported strategies to reduce vaccine purchase cost were online purchasing (81% Ped, 36% FM), prompt pay (78% Ped, 49% FM), and bulk order (65% Ped, 49% FM) discounts. Fewer than half of practices used strategies to increase payment; in a multivariable analysis, practices with ≥5 providers were more likely to use strategies compared with practices with fewer providers (adjusted odds ratio, 2.65; 95% confidence interval, 1.51-4.62). When asked if they had stopped purchasing vaccines because of financial concerns, 12% of Ped practices and 23% of FM practices responded 'yes,' and 24% of Ped and 26% of FM practices responded 'no, but have seriously considered.' CONCLUSIONS: Practices report variable payment for vaccination services from different payer types. Practices might benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery.
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