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Increasing immunization: a Medicaid managed care model
K Browngoehl1, K Kennedy, K Krotki
1Mercy Health Plan, Philadelphia, Pennsylvania, USA.
Insights
This study shows that immunization outreach programs, especially those with home visits, increase vaccination rates in children. Comprehensive strategies significantly improve immunization completion by 35 months of age.
Area of Science:
- Public Health
- Health Services Research
- Pediatric Medicine
Background:
- Childhood immunization rates are critical for public health.
- Managed care organizations can play a role in improving vaccination coverage.
- Outreach programs aim to overcome barriers to childhood immunizations.
Purpose of the Study:
- To evaluate the effectiveness of a comprehensive immunization outreach program.
- To determine the impact of specific program components, such as home visiting, on immunization rates.
Main Methods:
- Retrospective cohort study of 2511 children aged 30-35 months in a Medicaid managed care organization.
- Compared immunization rates for diphtheria-tetanus-pertussis, oral polio vaccine, measles-mumps-rubella, and Haemophilus influenza type b.
- Evaluated the outreach component by comparing treatment and non-treatment subgroups (N=1002).
Main Results:
- The immunization program, including home visiting, was associated with higher completed immunization rates at 35 months.
- Children receiving home visits showed significantly higher completed immunization rates.
- A trend of increased age-appropriate immunizations by 24 months was observed but was not statistically significant.
Conclusions:
- Comprehensive immunization strategies, including tracking, education, incentives, and home visiting, correlate with increased immunization rates.
- Home visiting was a key component associated with higher immunization completion by 35 months.
- Home visiting outreach did not significantly impact age-appropriate immunizations by 24 months within this specific program.
Objective:
To evaluate the impact of an immunization outreach program on immunization rates.
Setting:
A Pennsylvania independent practice association model managed care organization (100% Medicaid).
Design:
Retrospective cohort study (N = 2511) of children 30 to 35 months of age from two age cohorts that compared immunization rates for Advisory Committee on Immunization Practices schedules for diphtheria-tetanus-pertussis, oral polio vaccine, measles-mumps-rubella, and Haemophilus influenza type b. An evaluation of the outreach component of the program compared treatment and nontreatment subgroups of one age cohort (N = 1002).
Intervention:
The immunization program targeted approximately 19 000 members from birth to 6 years of age. The program components included computerized tracking and reminders, member and provider education, provider incentives, member incentives, and home visiting outreach.
Results:
Data indicate that the treatment group has higher completed immunization rates at 35 months of age than does the control group. Furthermore, data show that members with home visits have significantly higher completed immunization rates than do other members. The corresponding comparisons for age-appropriate immunizations by 24 months indicate a nonsignificant trend of increased rates.
Conclusion:
The data provide evidence supporting a correlation between comprehensive strategies (computerized tracking, member and provider education and incentives, and home visiting) and increased immunization rates. Those individuals who received home visits were more likely to complete an immunization series by 35 months of age than those who did not. However, within the Mercy Health Plan program, age-appropriate immunizations are not significantly affected by home-visiting outreach.