TY - JOUR
T1 - Policy implications of first-dollar coverage
T2 - A qualitative examination from the payer perspective
AU - Shortridge, Emily F.
AU - Moorea, Jonathan R.
AU - Whitmore, Heidi
AU - O'Grady, Michael J.
AU - Shen, Angela K.
PY - 2011
Y1 - 2011
N2 - Objectives. Immunization against potentially life-threatening illnesses for children and adults has proved to be one of the great public health successes of the 20th century and is extremely cost-effective. The Patient Protection and Affordable Care Act includes a number of provisions to increase coverage and access to immunizations for the consumer, including a provision for health plans to cover all Advisory Committee on Immunization Practicesrecommended vaccines at first dollar, or without cost sharing. In this study, we examined payers' perspectives on first-dollar coverage of vaccines and strategies to improve vaccination rates. Methods. This was a qualitative study, using a literature review and semistructured expert interviews with payers. Results. Four key themes emerged, including (1) the cost implications of the first-dollar change; (2) the importance of examining barriers to children, adolescents, and adults separately to focus interventions more strategically; (3) the importance of provider knowledge and education in increasing immunization; and (4) the effect of first-dollar coverage on those who decline vaccination for personal reasons. Conclusions. We determined that, while reducing financial barriers through first-dollar coverage is an important first step to increasing immunization rates, there are structural and cultural barriers that also will require collaborative, strategic work among all vaccine stakeholders.
AB - Objectives. Immunization against potentially life-threatening illnesses for children and adults has proved to be one of the great public health successes of the 20th century and is extremely cost-effective. The Patient Protection and Affordable Care Act includes a number of provisions to increase coverage and access to immunizations for the consumer, including a provision for health plans to cover all Advisory Committee on Immunization Practicesrecommended vaccines at first dollar, or without cost sharing. In this study, we examined payers' perspectives on first-dollar coverage of vaccines and strategies to improve vaccination rates. Methods. This was a qualitative study, using a literature review and semistructured expert interviews with payers. Results. Four key themes emerged, including (1) the cost implications of the first-dollar change; (2) the importance of examining barriers to children, adolescents, and adults separately to focus interventions more strategically; (3) the importance of provider knowledge and education in increasing immunization; and (4) the effect of first-dollar coverage on those who decline vaccination for personal reasons. Conclusions. We determined that, while reducing financial barriers through first-dollar coverage is an important first step to increasing immunization rates, there are structural and cultural barriers that also will require collaborative, strategic work among all vaccine stakeholders.
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U2 - 10.1177/003335491112600313
DO - 10.1177/003335491112600313
M3 - Review article
C2 - 21553668
AN - SCOPUS:79957869882
SN - 0033-3549
VL - 126
SP - 394
EP - 399
JO - Public health reports
JF - Public health reports
IS - 3
ER -