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Analysis of the Profitability of Adult Vaccination in 13 Private Provider Practices in the United States
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9 30 2019
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Source: Vaccine. 37(42):6180-6185
[PDF-117.81 KB]
Details:
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Alternative Title:Vaccine
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Personal Author:
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Description:Introduction:
Vaccination coverage among adults remains low in the United States. Understanding the barriers to provision of adult vaccination is an important step to increasing vaccination coverage and improving public health. To better understand financial factors that may affect practice decisions about adult vaccination, this study sought to understand how costs compared with payments for adult vaccinations in a sample of U.S. physician practices.
Methods:
We recruited a convenience sample of 19 practices in nine states. We collected data on the time and material costs of the vaccination work flow using a management survey and a time-motion study. We collected data on payments received for vaccine doses and vaccine administration for different payer types using a finance survey. We received complete cost and payment data from 13 of the 19 practices. We compared payments for vaccines to prices paid for vaccines. We calculated annual net revenue from vaccination services by combining payments received for vaccine doses and vaccine administration with estimated costs.
Results:
The extent to which vaccine payments exceeded vaccine prices varied by payer type, with per-dose payments from Medicare exceeding prices paid for 5 out of 5 vaccines , from Medicaid for 9 out of 14 vaccines, and from private health plans for 16 out of 21 vaccines. The median annual total net revenue from vaccination services was $90,343 at family medicine practices (range: $3,968 to $249,628), $28,267 at internal medicine practices (−$32,659 to $141,034) and $2,886 at obstetrics and gynecology practices (−$73,451 to $23,820).
Conclusions:
Payments received generally exceeded prices paid for most vaccines. Adult vaccination was profitable at the median of our sample, but there is wide variation in profitability due to differences in costs and payment rates across practices. This study provides evidence on the economic viability of adult vaccination that can help inform practices’ decisions whether to provide adult vaccines and contribute to keeping adults up-to-date with the recommended vaccination schedule.
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Pubmed ID:31495594
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Pubmed Central ID:PMC6778689
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