KEYWORDS:
Adolescent Immunization
Medicaid Managed Care
Barriers to Vaccination

BACKGROUND:
Historically, adolescents on Medicaid have low rates of immunizations and represent the largest and fastest growing population serviced by Medicaid. Gateway Health Plan (GHP) is the largest of three Medicaid HMO’s serving western and central Pennsylvania with over 29,000 adolescent members between 11-19 years of age.

OBJECTIVE(S):
To increase rates of adolescent immunizations by employing interdepartmental strategies designed to overcome member, provider, and system barriers to preventive health services.

METHOD(S):
A multidisciplinary workgroup was created that was led by Preventive Health and composed of representatives from various GHP departments. Our 2000 intervention sought to increase rates of immunizations among adolescent members, 11-13 years of age. Workgroup activities were designed to minimize member, provider, and system barriers to adolescent immunization. Specific strategies included member and provider outreach in addition to innovative interventions designed to comprehensively address all three barriers.

RESULT(S):
The 2001 HEDIS results confirm that the interventions were an exemplary approach to increasing rates of adolescent immunizations. Completed Series 1 adolescent immunization rates went from 34.55% in 1999 to 45.99% in 2000 (p-value=0.0071). Rates of Completed Series 2, Hepatitis B, MMR, and VZV increased from 1999 to 2000 as well. Hepatitis B, Completed Series 1 and Completed Series 2 increases were all statistically significant.

CONCLUSIONS(S):
By effectively targeting the entire health-related community of our members and striving to overcome member, provider, and system barriers, Gateway Health Plan was able to significantly increase rates of immunizations among high-risk Medicaid adolescents.

LEARNING OBJECTIVES:
Findings will help to formulize organization-wide strategies required to increase rates of immunizations among Medicaid youth. Results of the study will be useful to Medicaid insurance providers and primary health care providers.