Kids' Medicaid-Covered Flu Shots Put Docs at a Loss: Study

MONDAY Oct. 18, 2010 -- Flu vaccination rates among poor children would rise if Medicaid increased what it pays doctors for giving flu shots, a new report suggests.

Researchers at the University of Rochester Medical Center (URMC) looked at U.S. flu immunization rates for children between the ages of 6 months and 23 months during the 2005-2006, 2006-2007 and 2007-2008 flu seasons, and found that states with lower Medicaid reimbursement rates had lower vaccination rates.

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.

While this would increase Medicaid spending, it would reduce the significant financial costs associated with treating the flu, the researchers said. They noted that among U.S. children younger than 5 years old, the estimated annual cost of flu-related hospitalization is as much as $163 million and the annual cost of emergency room visits is as high as $279 million.

"The more children with access to seasonal flu vaccinations, the lower the overall burden will be on our health care system from the costs associated with treating influenza," study co-author and URMC pediatrician Dr. Peter Szilagyi said in the news release.

The study findings are published in the Oct. 18 online edition of the journal Pediatrics.

More information

The U.S. Centers for Disease Control and Prevention has more about children and flu vaccination.

Posted: October 2010


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