Enhancing Access to Vaccination Services by Reducing Financial Barriers

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Enhancing Access to Vaccination Services by
Reducing Financial Barriers

• Sheldon Weisgrau
• Kansas Health Institute
• May 2, 2006

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Why is this an issue?

• Out-of-pocket costs prevent some parents from
  having their children vaccinated on time.
• Limited insurance coverage (public or private)
  for children is a key factor in providers
  decisions to refer children to other sites for
  vaccinations (national studies).

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Strategies

• Goal is to make it as easy as possible for
  individuals and families to get the vaccinations
  they need
• To reduce barriers and enhance access to vaccine
  services, we can
• Reduce out-of-pocket costs
• Expand vaccination sites

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Ways to Reduce OOP Costs

• Provide free vaccinations
• Reduce administrative costs associated with
  vaccines
• Provide insurance coverage
• Reduce co-payments for vaccinations at the point
  of service

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Effectiveness

• The Task Force on Community Preventive Services
  found that reducing out-of-pocket costs is an
  effective way to increase access to immunization
  services.
• Various interventions showed a median improvement
  in vaccine coverage of 15
• Coverage improved among children (and adults) of
  different socioeconomic status
• Approach is effective whether used alone or as
  part of a multicomponent program

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Current Programs to Reduce OOP Costs

• Vaccines for Children
• Section 317
• State funding through the Kansas Immunization
  Program
• County and local support
• Insurance regulation

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Remaining Problems

• OOP costs for administration of vaccines
• OOP costs for travel to vaccine administration
  site, time off work, etc.
• Health insurance through ERISA plans
• May not cover immunizations
• May have deductibles and co-pays
• May have limits on preventive services

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Other Barriers

• Cost of the intervention
• Task Force on Community Preventive Services found
  that intervention cost 43 per additional vaccine
  administered (1 study)
• Complexities and fragmentation of mechanisms for
  payment of vaccinations

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