Vaccines too costly for docs to provide?

About 1 in 10 pediatricians and family physicians has seriously considered not providing childhood vaccines because of cost, according to the results of a recent survey.

Researchers from Colorado conducted a national survey of private pediatricians and family practitioners from April to September of 2011 regarding their level of satisfaction with reimbursement from insurers for vaccine purchase and administration. The survey was developed collaboratively with the Centers for Disease Control and Prevention.

The investigators found that physicians’ level of dissatisfaction with payment for vaccine administration varied considerably. Dissatisfaction was highest for Medicaid (63%), followed by the Children’s Health Insurance Program (56%), managed care organizations (48%), preferred provider organizations (38%), and fee for service (37%). Dissatisfaction levels didn’t vary as much for vaccine purchase, hovering between 41% and 52% for all types of payers.

Perhaps most importantly, the researchers found that 10% of responding family physicians already no longer provide vaccines although they see children. Also, 10% of all primary care respondents reported considering ceasing to provide vaccines because of cost.

Primary care physicians reported employing a number of strategies to help offset the uncertainty surrounding payment for vaccines, particularly the newer ones such as the human papillomavirus vaccine. In fact, 95% of respondents reported using at least 1 strategy; two-thirds (67%) reported using 3 or more.

The most commonly used strategy is to inform parents that their insurance may not pay for the vaccine and that they may be billed for it. Some physicians reported delaying offering vaccines when insurance coverage was uncertain. Others ask parents to determine whether their health plan will cover a vaccine before providing it. Some ask parents to sign a statement verifying that they will pay for the vaccine if their insurance doesn’t.

Sixty percent of responding physicians said that at least some parents denied or delayed vaccines because of cost issues. 

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