AFIX and Managed Care in Oregon: Applying the AFIX Model in a Non-Traditional Setting

Background:
The Oregon AFIX Program and Oregon's Medicaid program, Division of Medical Assistance Program (DMAP) have a long-standing partnership of working toward improved immunization coverage rates for two-year olds.
Since 2000, Oregon AFIX has provided annual assessments for managed care plans that contract with DMAP. Assessments are produced using data in ALERT, Oregon's Immunization Information System (IIS), and are presented to Quality Improvement Coordinators and Medical Directors. Practices and rates are discussed, and plan-level interventions are identified.

Setting:
Fifteen managed care plans that contract with DMAP.

Population:
VFC-eligible children throughout Oregon. Sixty-five percent of newborns and 61% of 1 and 2 year olds (more than 81,000 children) are eligible for VFC vaccine, according to 2008 population estimates.

Project Description:
This presentation will outline different types of collaborations among Oregon AFIX, DMAP, managed care plans, and ALERT IIS and will explore the outcomes of these interventions. Interventions include the use of ALERT's recall system by managed care plans to track and notify patients who are past due for immunizations, and the use of data systems from multiple agencies to investigate data quality issues that may affect rates. Oregon AFIX and managed care plans have also collaborated to conduct provider-level feedbacks with contracted providers.
Immunization rates for managed care plans have gradually increased since 2000. Although cause cannot be determined, it is believed that these collaborations have had a positive impact on immunization rates.

Results/Lessons Learned:
• AFIX methodology can be effectively applied in settings other than clinics.
• The successful relationship between Oregon AFIX, ALERT IIS, DMAP, and managed care plans is likely due to many factors, including increased attention on immunizations and a synergistic benefit derived from these collaborations.
• Assessing managed care plans can lead to innovative ways of promoting best practices among immunization providers.