Would more poor children receive flu shots if Medicaid reimbursed the doctors closer to the real cost of the shots?
Researchers at the University of Rochester Medical Center (URMC) believe the number would increase if doctors were not losing money each time they immunized a child on Medicaid against the flu.
The researchers looked at flu immunization rates for children 6 to 23 months during 2005 to 2006, 2006 to 2007, and 2007 to 2008 flu seasons and found those paid by Medicaid had a much lower vaccination rate.
“Reimbursement rates ranged from $2 in Colorado, Connecticut and Hawaii to almost $18 in New York, with the average reimbursement rate $9. In a previous study, the researchers had calculated that the actual cost to doctors’ offices for administering a vaccine was $20.”
” ‘In most states the reimbursement from Medicaid is far below the actual cost. This may create an obvious disincentive when physicians’ offices lose money every time they give a flu shot, even though vaccines are provided for free,” lead author Dr. Byung-Kwang Yoo, an assistant professor in the Department of Community and Preventive Medicine, said in a URMC news release.”
“Using mathematical models, Yoo and colleagues calculated that for every extra dollar paid by Medicaid, flu vaccination rates among poor children would increase by 0.6 to 0.9 percent. That means a $10 reimbursement increase would raise vaccination rates among children in low-income families by up to 10 percent.”
The idea is that by paying a higher reimbursement rate on the front end, more children would be immunized against the flu and less children would need more expensive medical care later to treat the actual flu.
Do you think more poor children would get immunizations if the Medicaid reimbursements were higher? Do you think the doctors think about losing money on each of those shots and don’t advertise to those patients they could get the shot there? Do you think the parents just don’t bring them in and it has nothing to do with what is being reimbursed? Does it make sense to pay more on the front-end to save on the back end?