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CDC/SAM Immunization Small Grants Program, 2005 Innovation in Improving Immunization Delivery to Children and/or Adolescents
Investigating Barriers to Accessing Information Regarding Private Medical Insurance Coverage for Adolescent Vaccinations
Sponsored by
the
Society
for Adolescent Medicine and the
Centers for Disease
Control and Prevention
Investigators:
Julie Boom, M.D., and
Amy Middleman, M.D., M.P.H., M.S.E.D.
An often-cited barrier in the effective immunization of adolescents is the financial burden of vaccination. With new immunization recommendations and new vaccines specifically for adolescents, we sought to uncover underlying financial factors that could affect the uptake of new vaccine recommendations for adolescents. Through informal phone calls to private insurance companies in Texas, however, we encountered barriers to accessing a knowledgeable representative capable of releasing information regarding vaccination plan options and reimbursements. We therefore determined that our study actually required a more fundamental component of the investigation, including the primary obstacles to accessing information regarding insurance coverage for newly recommended adolescent vaccines.
Based on this premises, our proposal aims to investigate the primary factors that impede accessing information regarding insurance coverage for newly recommended adolescent vaccines. The specific objectives include:
Gathering data regarding the barriers to accessing health insurance coverage information for new ACIP adolescent vaccination recommendations. Investigating the association of these barriers with characteristics of private insurance companies, including size and type of company and the type and number of health plans each company offers employers. Analyzing any available information regarding benefits and physician reimbursement for adolescent vaccination.
Through telephone surveys, we assess the barriers to accessing reimbursement information from private insurance companies in Texas, New York, and Oregon. The stepwise survey includes 3 main themes/tiers representing pervasive situations we encountered when requesting information from private health insurance companies. These 3 major themes include: (1) access to key informants (including reaching a human contact); (2) availability of reimbursement information (willingness to respond to surveys, and identifying the key person with reimbursement information); and (3) attainment of adolescent vaccine reimbursement information (actual reimbursement data).
After gathering data regarding these barriers, we will investigate the association of these barriers with characteristics of private insurance companies and analyze any available information regarding benefits and physician reimbursement for adolescent vaccination. Results from this study will influence future research plans to investigate these barriers nationally and determine the impact of physician reimbursement on adolescent immunization coverage and healthcare utilization.
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