enhancing immunization services yavapai county community health services december 2007
TRANSCRIPT
Enhancing Immunization Services
Yavapai County Community Health Services
December 2007
Yavapai CountyCommunity
Health Services(YCCHS)
Community Health Center
Public Health Department
Immunization DataJan-Nov 2007 Total vaccines given = 13,666 Given to under 18 year olds = 9,809 Given to adults = 3,857 Number of vaccines available = 29
Add Influenza – OVER 20,000/shots/year
The Problem
Travel Immunization Clinic Currently administered by the Community
Health Center A non-traditional (CHC) service – a logical
experiment gone wrong Only provider in Yavapai County A money loser – due to health insurance
contracts with fixed ceilings for reimbursement County indirectly subsidizes travelers
The Solution
Public Health Department Cash up front for travel immunizations Patients deal directly with insurance
companies so no billing woes for department Patients are supplied with detailed insurance-
ready receipts The Health Department is paid in full up front Patients don’t need to travel to Phoenix The program is self-sufficient
The Variables
The (mostly) unknowns Patients’ reactions to having to deal directly
with insurance companies Market variables
Supply and demand Outbreaks/Panics Price swings New vaccines Pharmaceutical industry/Patents
Associated effects on revenue projections
Zostarvax (Shingles)
-100
-50
0
50
100
150
200
$
Cost Billed Paid RealLoss
Opp.Loss
TotalLoss
Recommendations
Transfer all non-CHC immunization functions from the Community Health Center to Public Health
Create a stand-alone, cash-only, travel clinic Round up all vaccine costs to the nearest dollar Adopt the following fee schedule:
Vaccine cost = purchase price plus $10.00 Administration fee = $20.00/shot Consultation Fee = $40.00/planning visit
Effective February 1, 2008
Pros Prices are set at a reasonable market rate Price changes – up or down – are automatic
without constant approvals by the Board of Supervisors
Travel immunizations will be self-sufficient Fewer transactions with insurance companies Clinic patients will still be covered for
immunizations Full indirect costs collected Continued service and convenience to the
community Very comparably priced
Cons
Numerous variables Projection assumptions may be flawed Paying up front for services may not be
agreeable to all
Endorsements
Health Resources And Services Administration
Prescott Free Clinic Board of Directors YCCHS Administration Yavapai Board of Health
Recommendations
Transfer all non-CHC immunization functions from the Community Health Center to Public Health
Create a stand-alone, cash-only, travel clinic Round up all vaccine costs to the nearest dollar Adopt the following fee schedule:
Vaccine cost = purchase price plus $10.00 Administration fee = $20.00 Consultation Fee = $40.00
Effective February 1, 2008