Top 5 tips to improve your practice's vaccine process

For those practices that do not routinely offer vaccinations, or are struggling to maintain a successful program, we would like to offer a basic outline of the process. Adhering to this process should deliver healthier, vaccinated patients and increased revenue, and will represent an important step towards meeting the preventative health measures in value-based care.

Further reading: How to improve your practice's vaccine procurement process

Review a comprehensive immunization training guide.
The Centers for Disease Control and Prevention, American Academy of Pediatrics (AAP) and many state health departments offer formal training guides to assist with setting up a successful and complete vaccination program for your practice. (See a list of recommended resources below.)

Appoint an office vaccine coordinator with specific duties.
As you practice medicine, there will be appropriate areas requiring routine oversight.

Review storage options.
There are strict requirements regarding the refrigeration, temperature monitoring and systems of storage to ensure the integrity of the vaccine. There are options with pros and cons (visit bit.ly/vaccine-storage for some good insight on this topic). Review your general liability insurance with your broker to see if you need a rider to cover the vaccine you store. Practices providing vaccines for children to low-income patients should review those requirements from your state public health department.

Perform a financial review.
There are a finite number of vaccines available. You should not pay any more than necessary for the schedule you prefer. Take the time to crunch your numbers, and understand the benefits and drawbacks of the various purchasing options. Ordering your vaccine from a distributor generally will result in the highest cost. Ordering direct from the manufacturer is a less expensive option. You may also order directly from the manufacturer under several contracted options:

• Internal vaccine contracts; (Some manufacturers have a contract that they offer to single offices that meet their purchasing requirements. PediaFed pricing is better than this internal contract because we return our admin fees in the form of rebate)

• Large GPO contracts, usually found in hospitals (these are not vaccine directed and do not have the level of vaccine discounts found in other options, according to the manufacturers); or

• Physician buying groups (these usually receive the highest level of discount available)

Purchasing groups that return unspent administrative fees can significantly lower cost. You should be able to calculate the rebate amount your office will receive by reviewing the buying group pricing grids. Careful attention to this part of the process should provide a cushion towards fluctuating insurance reimbursement rates and give your practice the lowest vaccine cost available.

Set your fee.
This is a critical part of the process. The revenue from providing vaccinations should contribute appropriately towards your practice overhead. For help with this process, we recommend the "Business Case for Pricing Vaccine" guide from the AAP. This reference states that most practices will have overhead costs from routine immunization of 17%-28% over the cost of the vaccine.

Vaccine Resources:

American Academy of Pediatrics (AAP) Immunization Training Guide: https://www.aap.org/en-us/Documents/immunizations_training_guide.pdf

AAP Immunization Quality Improvement: https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/immunization/Pages/quality-improvement.aspx

AAP Guide for Vaccine Pricing (AAP):https://www.aap.org/en-us/Documents/immunizations_thebusinesscase.pdf

CDC Vaccination Resources : http://www.cdc.gov/vaccines/events/niiw/ed-resources/partner-resources.html

American Academy of Family Physicians (AAFP) Vaccine Coding Guidance:

http://www.aafp.org/practice-management/payment/coding/admin.html

Vaccine Storage and Safety Guidelines (from pediatric practice consultant Chip Hart): http://chipsblog.pcc.com/vaccine-storage-and-safety-guest-blog-and-survey/

Alan Johnson, MD, FAAP, has been a practicing pediatrician for SF Bay Pediatrics in San Francisco for 40 years. He completed an immunology fellowship from the University of California, San Francisco and is a clinical professor of pediatrics at UCSF and a consultant in infectious disease. He has led the Pediatric Federation community from its inception.

Kathy Chebib, BS, MT, a trained medical technologist, has been a pediatric business manager and practice administrator for more than 30 years. She works for Golden Gate Pediatrics in San Francisco, and helps with the cooperative endeavors of Pediatric Federation.