KEYWORDS:
Health Plan, Assessment, AFIX, HEDIS

BACKGROUND:
Health plans are required to assess their immunization rates using HEDIS criteria on a regular basis, and, in Oregon, all plans have quality improvement managers interested in improving practices. The desire of health plans to improve their immunization practices and the potential for reaching large populations suggested that an AFIX partnership with health plans could be highly beneficial.

OBJECTIVE:
To demonstrate the unique applicability and value of AFIX at the health plan level.

METHOD:
Immunization program staff assessed 17 plans using CASA and presented results at one meeting to the plan quality improvement managers. Health plan data were compared to each other, which provided unique opportunities to discuss differences in trends and practices among the plans. HEDIS rates were presented, NIS-type rates were compared, and missed opportunities and late starts were evaluated.

RESULT:
Health plan managers acknowledged the unique capabilities of the AFIX assessment and feedback process, and understood the possibilities for assisting them in improving quality service goals. Additionally, managers from Oregon’s Office of Medical Assistance Programs, which contracts with these major health plans, expressed enthusiastic support for the AFIX process. Their partnership has been invaluable in conducting a research study, stimulated by AFIX, to identify rates and issues specific to the Medicaid populations served by each health plan.

CONCLUSION:
Improvement in immunization rates and practices is crucial for health plans, and AFIX can be a powerful tool to meet those needs. Improved HEDIS immunization rates, detailed understanding of system-wide issues, and the potential for targeted interventions on large populations are benefits uniquely available to health plans through AFIX.

LEARNING OBJECTIVES:
To understand the unique benefits of partnering with health plans and to understand methods for assessment and feedback at a system level.