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BALTIMORE — Three-quarters of pediatric practices lose money on vaccinations, based on a small study of 34 Georgia practices.
For the study, the researchers stratified the practices by percentage of patients on the federal Vaccines for Children (VFC) program. “Only about 25% of practices receive a positive net return from vaccinating children—the higher the number of VFC patients, the higher the net loss,” said Margaret Coleman, Ph.D., a health economist with the Centers for Disease Control and Prevention and the lead investigator.
The researchers surveyed Georgia pediatricians from three organizations, one of which was the Georgia chapter of the American Academy of Pediatrics. A total of 34 practices provided enough information to be included in the analysis, which was presented at the annual meeting of the Pediatric Academic Societies.
Any child who was on Medicaid or who was uninsured was eligible for VFC and was considered a public payer. Practices received vaccines for these patients free of charge.
Total costs included practice costs, vaccine costs, labor, and overhead. Private reimbursement included administration and vaccine; public reimbursement included only administration.
The average value of the number of doses reported on hand at the practice was $133,644, and the average value of the combination of doses on hand and on order was $274,644.
The median values were $58,107 and $123,500, respectively.
Almost all of the practices ordered vaccines on a monthly basis. However, more expensive vaccines (such as human papillomavirus, or HPV) usually were ordered on a bimonthly basis. “For a small business, this is a lot of cash to be tied up,” said Dr. Coleman.
The researchers found that for children on VFC, practices lost $17 if the child showed up for only one dose.
If the child received five doses, the practice lost almost $12 per child.
“Across the board—private or public pay—it's a loss if a child shows up for just one vaccine dose,” she said.
“The bottom line is that the practices that fall into the 0%–10% [VFC-eligible children] group earn a small return on vaccination when weighted between private-pay and public-pay patients. For all other practices, the losses for VFC-eligible children outweigh the gains from the private-pay patients,” Dr. Coleman said.
In addition, the researchers found that the greater the number of VFC-eligible patients seen in a practice, the lower the pediatrician income. The number of VFC-eligible patients in a practice was directly related to the time spent counseling patients/parents. (See table.)
The practices with 0%–10% of patients being VFC eligible hired more than half of the registered nurses in the entire sample.
Dr. Coleman said it's possible that RNs in these practices may take on more of the vaccine counseling, freeing up physicians for other tasks.
Dr. Coleman reported that she had no conflicts of interest relevant to this study.
ELSEVIER GLOBAL MEDICAL NEWS
BALTIMORE — Three-quarters of pediatric practices lose money on vaccinations, based on a small study of 34 Georgia practices.
For the study, the researchers stratified the practices by percentage of patients on the federal Vaccines for Children (VFC) program. “Only about 25% of practices receive a positive net return from vaccinating children—the higher the number of VFC patients, the higher the net loss,” said Margaret Coleman, Ph.D., a health economist with the Centers for Disease Control and Prevention and the lead investigator.
The researchers surveyed Georgia pediatricians from three organizations, one of which was the Georgia chapter of the American Academy of Pediatrics. A total of 34 practices provided enough information to be included in the analysis, which was presented at the annual meeting of the Pediatric Academic Societies.
Any child who was on Medicaid or who was uninsured was eligible for VFC and was considered a public payer. Practices received vaccines for these patients free of charge.
Total costs included practice costs, vaccine costs, labor, and overhead. Private reimbursement included administration and vaccine; public reimbursement included only administration.
The average value of the number of doses reported on hand at the practice was $133,644, and the average value of the combination of doses on hand and on order was $274,644.
The median values were $58,107 and $123,500, respectively.
Almost all of the practices ordered vaccines on a monthly basis. However, more expensive vaccines (such as human papillomavirus, or HPV) usually were ordered on a bimonthly basis. “For a small business, this is a lot of cash to be tied up,” said Dr. Coleman.
The researchers found that for children on VFC, practices lost $17 if the child showed up for only one dose.
If the child received five doses, the practice lost almost $12 per child.
“Across the board—private or public pay—it's a loss if a child shows up for just one vaccine dose,” she said.
“The bottom line is that the practices that fall into the 0%–10% [VFC-eligible children] group earn a small return on vaccination when weighted between private-pay and public-pay patients. For all other practices, the losses for VFC-eligible children outweigh the gains from the private-pay patients,” Dr. Coleman said.
In addition, the researchers found that the greater the number of VFC-eligible patients seen in a practice, the lower the pediatrician income. The number of VFC-eligible patients in a practice was directly related to the time spent counseling patients/parents. (See table.)
The practices with 0%–10% of patients being VFC eligible hired more than half of the registered nurses in the entire sample.
Dr. Coleman said it's possible that RNs in these practices may take on more of the vaccine counseling, freeing up physicians for other tasks.
Dr. Coleman reported that she had no conflicts of interest relevant to this study.
ELSEVIER GLOBAL MEDICAL NEWS
BALTIMORE — Three-quarters of pediatric practices lose money on vaccinations, based on a small study of 34 Georgia practices.
For the study, the researchers stratified the practices by percentage of patients on the federal Vaccines for Children (VFC) program. “Only about 25% of practices receive a positive net return from vaccinating children—the higher the number of VFC patients, the higher the net loss,” said Margaret Coleman, Ph.D., a health economist with the Centers for Disease Control and Prevention and the lead investigator.
The researchers surveyed Georgia pediatricians from three organizations, one of which was the Georgia chapter of the American Academy of Pediatrics. A total of 34 practices provided enough information to be included in the analysis, which was presented at the annual meeting of the Pediatric Academic Societies.
Any child who was on Medicaid or who was uninsured was eligible for VFC and was considered a public payer. Practices received vaccines for these patients free of charge.
Total costs included practice costs, vaccine costs, labor, and overhead. Private reimbursement included administration and vaccine; public reimbursement included only administration.
The average value of the number of doses reported on hand at the practice was $133,644, and the average value of the combination of doses on hand and on order was $274,644.
The median values were $58,107 and $123,500, respectively.
Almost all of the practices ordered vaccines on a monthly basis. However, more expensive vaccines (such as human papillomavirus, or HPV) usually were ordered on a bimonthly basis. “For a small business, this is a lot of cash to be tied up,” said Dr. Coleman.
The researchers found that for children on VFC, practices lost $17 if the child showed up for only one dose.
If the child received five doses, the practice lost almost $12 per child.
“Across the board—private or public pay—it's a loss if a child shows up for just one vaccine dose,” she said.
“The bottom line is that the practices that fall into the 0%–10% [VFC-eligible children] group earn a small return on vaccination when weighted between private-pay and public-pay patients. For all other practices, the losses for VFC-eligible children outweigh the gains from the private-pay patients,” Dr. Coleman said.
In addition, the researchers found that the greater the number of VFC-eligible patients seen in a practice, the lower the pediatrician income. The number of VFC-eligible patients in a practice was directly related to the time spent counseling patients/parents. (See table.)
The practices with 0%–10% of patients being VFC eligible hired more than half of the registered nurses in the entire sample.
Dr. Coleman said it's possible that RNs in these practices may take on more of the vaccine counseling, freeing up physicians for other tasks.
Dr. Coleman reported that she had no conflicts of interest relevant to this study.
ELSEVIER GLOBAL MEDICAL NEWS