Benefit of IIS Data to Health Plans In New York State

Background:  The collaboration between the New York State Immunization Information System (NYSIIS) and health insurance plans has proven to be mutually beneficial.  New York State Public Health Law (PHL) 2168 requires providers to report immunization administration to NYSIIS within 14 days.  Health insurance plans periodically receive data extracts from NYSIIS for children participating in their plans.  The plans use the data to meet state and federal reporting requirements and to assess individual providers.  In cases where the plans find providers who have under reported, they encourage them to increase the reporting to NYSIIS and in some instances actually reimburse them for reporting to NYSIIS through incentive programs.

Setting:  New York State outside of New York City

Population:  Children less than 19 years of age.

Project Description:  NYSIIS wanted to assess how the immunization data needs of health insurance plans were best met.  NYSIIS developed a survey for participating health insurance plans to complete.  The survey’s purpose was to find out how often they retrieved data from NYSIIS; how complete they found NYSIIS data; and what interventions (if any) they took with their provider(s).

Results/Lessons Learned:  Continued partnership between NYSIIS and the health insurance plans will ensure increased data quality and reporting timeliness. Both parties benefit from this collaboration and ultimately it is the children who gain in being properly immunized.