Is reimbursement for childhood immunizations adequate? evidence from two rural areas in colorado

Public Health Rep. May-Jun 2001;116(3):219-25. doi: 10.1093/phr/116.3.219.

Abstract

Objective: To assess adequacy of reimbursement for childhood vaccinations in two rural regions in Colorado, the authors measured medical practice costs of providing childhood vaccinations and compared them with reimbursement.

Methods: A "time-motion" method was used to measure labor costs of providing vaccinations in 13 private and public practices. Practices reported non-labor costs. The authors determined reimbursement by record review.

Results: The average vaccine delivery cost per dose (excluding vaccine cost) ranged from $4.69 for community health centers to $5.60 for private practices. Average reimbursement exceeded average delivery costs for all vaccines and contributed to overhead in private practices. Average reimbursement was less than total cost (vaccine-delivery costs + overhead) in private practices for most vaccines in one region with significant managed care penetration. Reimbursement to public providers was less than the average vaccine delivery costs.

Conclusions: Current reimbursement may not be adequate to induce private practices to provide childhood vaccinations, particularly in areas with substantial managed care penetration.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child Health Services / economics*
  • Colorado
  • Community Health Centers / economics*
  • Cost Allocation
  • Health Maintenance Organizations / economics
  • Humans
  • Immunization Programs / economics*
  • Insurance, Health, Reimbursement / classification
  • Insurance, Health, Reimbursement / statistics & numerical data*
  • Medicaid
  • Medical Assistance
  • Personnel Staffing and Scheduling / economics
  • Private Practice / economics*
  • Rural Health Services / economics*
  • State Health Plans / economics
  • Time and Motion Studies
  • United States