Abstract:
OBJECTIVE:The goal was to describe variable costs to providers of delivering childhood immunizations. METHODS:We documented variable costs (costs that vary with the amount of services rendered), including time spent by pediatric staff members and physicians on immunization-related activities, as well as supply costs and medical waste disposal costs. Ten private pediatric practices in the Denver, Colorado, metropolitan area participated in the study. Among the 7 practices that provided us with payment data, 8 health plans were mentioned by > or = 2 practices. There were 37 different agreements between the health plans and practices for vaccine administration payments. RESULTS:The total documented variable cost per injection (excluding vaccine cost) averaged $11.51, calculated from the following categories: nursing time, $1.71; billing services, $2.67; nonroutine services, $1.64; registry use, $0.96; physician time, $4.05; supplies, $0.36; medical waste disposal, $0.12. Nonroutine activities primarily included performing vaccine inventory and ordering, providing vaccination records to requesters, and answering parent telephone questions about vaccinations. With the use of a simulation model to compensate for the small number of participating practices, the calculated total variable cost per injection was $11.83. When 2 vaccines were administered, we compared the sum of the 2 payments with the sum of the 2 variable costs ($23.02). More than one third of the payment agreements (13 of 37 agreements) paid the practices less than the combined variable costs for 2 immunizations. CONCLUSION:This study shows that the variable costs of vaccine administration exceeded reimbursement from some insurers and health plans.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Glazner JE,Beaty B,Berman Sdoi
10.1542/peds.2009-1542Hsubject
Has Abstractpub_date
2009-12-01 00:00:00pages
S492-8eissn
0031-4005issn
1098-4275pii
124/Supplement_5/S492journal_volume
124 Suppl 5pub_type
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