Abstract
Objective
To assess rates of immunization; costs of conducting clinics; and reimbursements for
a school-located influenza vaccination (SLIV) program that billed third-party payers.
Methods
SLIV clinics were conducted in 19 elementary schools in the Denver Public School district
(September 2010 to February 2011). School personnel obtained parental consent, and
a community vaccinator conducted clinics and performed billing. Vaccines For Children
vaccine was available for eligible students. Parents were not billed for any fees.
Data were collected regarding implementation costs and vaccine cost was calculated
using published private sector prices. Reimbursement amounts were compared to costs.
Results
Overall, 30% of students (2784 of 9295) received ≥1 influenza vaccine; 39% (1079 of
2784) needed 2 doses and 80% received both. Excluding vaccine costs, implementation
costs were $24.69 per vaccination. The percentage of vaccine costs reimbursed was
62% overall (82% from State Child Health Insurance Program (SCHIP), 50% from private
insurance). The percentage of implementation costs reimbursed was 19% overall (23%
from private, 27% from Medicaid, 29% from SCHIP and 0% among uninsured). Overall,
25% of total costs (implementation plus vaccine) were reimbursed.
Conclusions
A SLIV program resulted in vaccination of nearly one third of elementary students.
Reimbursement rates were limited by 1) school restrictions on charging parents fees,
2) low payments for vaccine administration from public payers and 3) high rates of
denials from private insurers. Some of these problems might be reduced by provisions
in the Affordable Care Act.
Keywords
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Article info
Publication history
Accepted:
January 21,
2014
Received:
October 21,
2013
Footnotes
Dr Daley received an honorarium from McGraw-Hill publishers for writing a textbook chapter on immunizations.
The other authors declare that they have no conflict of interest. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the US Centers for Disease Control and Prevention.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
