BACKGROUND:
Oregon was one of the first states to participate in the GPRA Project aimed to increase Medicaid immunization rates for children. The statewide registry was the source of all assessment data. Early in the project it became clear that the percent of children starting late was much higher in the Medicaid population than in the general population of the same age; this finding stimulated a separate study into the causes of these late starts.

OBJECTIVE:
The overall objectives of the long-term collaboration between the Immunization Program, the statewide registry, and OMAP are to: improve the coverage rate of Medicaid children; provide the Medicaid Office with relevant data on the immunization rates and practices of their contracting health plans; standardize the assessment methodology among all health plans; assess how length of enrollment affects coverage levels; provide immunization trends to policymakers and legislators.

METHOD:
Oregon used ALERT data to extract records based on two criteria in 2004: 1) all children <36 months of age regardless of length of Medicaid enrollment and 2) all children continuous enrolled for eight months. Oregon assessed each managed care plan and FFS for both criteria.

RESULT:
-43133 rates improved: 58.5% (2004) compared with 40.2% (2003)
-Time of enrollment was found to matter
-Each plan found the information actionable and useful
-Relevant discussion of immunization practices
-Rates using GPRA methodology (4:3:1 @ 19-35 months) improved from 62% to 78% over a period of 6 years

CONCLUSION:
Quality Improvement Managers need meaningful immunization measures and specific tools to help raise rates. Registry data, reports, and AFIX feedback sessions all work together to achieve this goal.

LEARNING OBJECTIVES:
Describe how collaboration and registry data were the key components to improvements in Medicaid childhood immunization rates.