Learning Objectives for this Presentation:
By the end of the presentation participants will be able to:
- Describe measurement methodologies being implemented in this GPRA Immunization Project
- Identify examples of successes and barriers to project implementation
- Apply lessons learned to future immunization program planning

Background:
In 1993 the Government Performance and Results Act (GPRA) was enacted requiring federal agencies to develop measurable goals that demonstrate performance accomplishments. The Immunization Goal was developed by CMS in conjunction with the State Medicaid Directors. CMS has partnered with CDC for technical assistance. Collaboration with state immunization programs was key to implementing this initiative.

Objectives:
To increase the percentage of fully immunized Medicaid two-year-olds.
To establish a working relationship between Medicaid and immunization at the state level.

Methods:
Fifty of 51 states volunteered to participate. Each State determined their definitions of two-year old, Medicaid eligible, and fully immunized; data collection method; and period of time covered by measurement. After the baseline measure was completed, the states measured each of the next three years using the same methodology. They implemented a variety of interventions and determined a target rate of improvement to be achieved. Immunization rates were compared against previous years - not against other states.

Results:
The baseline rates were lower than predicted. Some of the states had to work hard to show improvement while others had to maintain their excellent rates. Of the 50 states that volunteered for this project, 46 completed the reporting.

Conclusions:
All states demonstrated success in this project whether in actual improved rates of fully immunized children or in taking action to establish a data collection system and supporting infrastructure to sustain a quality measurement process. All state Medicaid agencies indicate they plan to continue quality measurement in immunization as well as other areas of Medicaid health promotion as part of their program cost reduction efforts.