Time spent on vaccine education a huge factor in cost

Physicians know that vaccination is important, but they also know that it can cost a lot of time-and revenue-to convince patients who are against or hesitant about vaccines to see their benefit.                                                   

Two new studies highlight the amount of revenue that practices can receive from vaccination programs, as well as the costs associated with educating patients about vaccines-particularly when vaccines are ultimately refused.

The first study, published in Medical Care, reviewed the cost of providing vaccination services at four internal medicine, four family medicine, two pediatric, two OBGYN, and two community health clinics in North Carolina. The study team assessed all vaccination-related activities in the provider office and surveyed providers on vaccine management costs.

The mean cost of each vaccine administration was $14, with costs ranging from $10 to $23 across all practice types, according to the report. When providers received the maximum reimbursement for these vaccinations, the practices reported revenue for vaccination services.

However, when only minimum payments from vaccinations were received, only pediatric and family medicine practices-where vaccines cost $10 and $17, respectively-reported revenue. Internal medicine and OBGYN practices, where vaccines cost $23, reported equal costs and payment. Community health clinics, where vaccines cost just $15, reported losses on vaccine administrations when minimum payments were received, according to the report.

While vaccination programs resulted in at least small revenue in most cases, the research team reported that the results highlight the need for system improvements that will make vaccinations more financially sustainable for providers.

Benjamin Yarnoff, PhD, a senior research economist at RTI International and one of the authors of both reports, said the key to creating a financially sustainable vaccination services lies in increasing volume and vaccine acceptance, as well as system-wide changes that will increase support for clinicians.

One significant issue identified in the report was the problem of identifying patients who needed vaccines, the time spent educating them, and the time and revenue lost by the clinician if a patient did not agree to be vaccinated.

“We were surprised by the number of patients that were considered for vaccination and received provider time related to vaccination, but did not require or accept a vaccination,” Yarnoff said. “Clinicians should consider ways to more effectively identify patients in need of vaccination in order to maximize vaccine volume and reduce time spent with patients that do not need a vaccination.”

In a second report, Yarnoff and other researchers focused simply on cost, but also highlighted the financial cost of time spent with patients who decline vaccination.

“Costs are driven by economies of scale, and time spent with patients that do not end up receiving a vaccination,” Yarnoff said.

The second study, published in Vaccine, found vaccines cost roughly $7 for family practices to administer, $8 for internal medicine practices, and $43 for OBGYN practices. Coincidentally, 68% of the patients counseled about vaccination at OBGYN practices declined, the report notes.

Yarnoff said he hopes the studies will help practices recognize the importance of screening patients for vaccine needs and acceptance as a way to create sustainable vaccination programs.

“We hope that this report will encourage practices that vaccination can be a financially sustainable service and support them in identifying ways to increase the financial sustainability of their vaccination programs,” he said.