Physicians know the health value of vaccinations and want to provide patients with this important service. But historically, there’s been a gap between vaccine costs and the reimbursement practices receive for administering them.
Though some physicians still feel vaccinations are cost-neutral or even a financial drain, many practices have taken steps to create robust vaccination programs that actually contribute to their bottom line.
“One of my biggest challenges is getting physicians to understand that vaccinations are simple, easy and economically they make sense, and we’re doing the right thing for patients,” says Jason Goldman, MD, an internal medicine practitioner in Coral Springs, Florida, and governor of the Florida chapter of the American College of Physicians.
With the Centers for Disease Control and Prevention’s recent update to adult vaccination guidelines urging more immunizations, now is a good time for physicians to review their programs.
The reality of vaccinations in practice
Physicians agree that vaccinating patients is medically essential, but it takes some understanding of the business of vaccines to do it in a way that makes financial sense.
Since vaccines are expensive to purchase and reimbursement often was not robust or timely in the past, practices were left paying out-of-pocket for a service on which they often lost money.
That needn’t happen today. Goldman attributes some of the problems physicians have now to poor business decisions and a lack of knowledge about reimbursement practices.
In fact, practices can actually make a profit based on billing for the vaccination itself, in addition to the administration codes. But to do so, physicians have to understand supply and demand, vaccination recommendations, the reimbursement procedures and they must stay on top of the business of vaccines.
Here are eight ways physicians can make vaccinations more cost-effective:
1 Practice good inventory management
If vaccines sit in the refrigerator unused, the practice has incurred an expense it may not recoup.
While vaccines have long shelf lives, practices that inventory well know how much they have on hand, how much they need and when to purchase more. In addition, they needn’t pay for the vaccine until long after the payer reimburses them for vaccinating the patient. With deferred billing and timely reimbursements today, there’s no reason to lose money on vaccine purchases.
But someone must track fluctuations in the demand for vaccines by reviewing previous vaccination records and scheduled appointments, then use that data to assess how many vaccinations may be needed in the next 90 days. That way, a practice can keep enough inventory on hand to meet demand. Practice staff should order every two to four weeks to best keep supply in line with expected demand.