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States With High Rates: How Do They Do It?

States With High Rates: How Do They Do It?. Sheldon Weisgrau Sunee Mickle Laura Harrington Kansas Health Institute October 12, 2006. Outline. Current Kansas financing “system” Experience of other states Finance & supply policies State specific programs Ongoing research.

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States With High Rates: How Do They Do It?

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  1. States With High Rates: How Do They Do It? Sheldon Weisgrau Sunee Mickle Laura Harrington Kansas Health Institute October 12, 2006

  2. Outline • Current Kansas financing “system” • Experience of other states • Finance & supply policies • State specific programs • Ongoing research

  3. Immunization Financing in Kansas • Mix of public and private funding • Federal, state, and local government • Private insurance • Out-of-pocket • Almost all children are at least partially covered for the costs of immunization

  4. Kansas Immunization Spending

  5. State Immunization Finance & Supply Policy • The financing “system” is more or less the same in every state • Size of the pie may vary • Size of the slices may vary • But the ingredients are the same • States “mix” the ingredients differently in supplying vaccines to providers

  6. Vaccine Supply Policies • Universal (MA, NH, NM) • Universal Select (CT, NC, SD) • VFC & Uninsured (FL, MN, UT) • VFC & Uninsured Select (KS, IL, TX) • VFC Only (CO, IA, MO, NE, OK)

  7. Universal Purchase:Financing Methods • Idaho: VFC, 317, & SGF • New Mexico: VFC, 317, SGF, & voluntary contributions from insurers • New Hampshire: VFC, 317, SGF, & mandatory insurer contributions • South Dakota: VFC, 317, & SGF (but doesn’t cover newer vaccines)

  8. Universal Purchase: Controversy • Can new Universal Purchase states buy vaccines at the CDC contract rate?

  9. State Interventions • Provider Assessment & Feedback • Education & Outreach • Community Collaboration • Other

  10. State Programs to Boost/Sustain Rates • Provider Assessment & Feedback • Mandatory reporting to registry (CT) • Regular assessment, updates, and comparisons of provider performance (MA, CT, MT) • Monthly tracking and targeting of kids who are late (CT)

  11. State Programs to Boost/ Sustain Rates (continued) • Education & Outreach • State epidemiologists assigned to regions to answer questions and provide support (MA) • Immunization coordinators placed at LHDs (CT) • Intensive education and “selling” of VFC program (AL) • Peer in-service education program (MI) • Targeted information to day care providers and school nurses (RI) • Regional training programs for providers (IA)

  12. State Programs to Boost/ Sustain Rates (continued) • Community Collaboration • Local bilingual parents serve as liaisons between health departments and parents (RI) • LHDs responsible for distributing VFC vaccines to local providers (WA) • Other • Walk-in immunization sites assign patients to medical homes (RI) • Physician Advisory Committee (RI)

  13. Ongoing Research • Additional information on programs in states with consistently high immunization rates and states that have improved their rates • Steps to develop and implement initiatives • Cost • Pros and cons for Kansas • Cost of universal purchase in Kansas

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