Ohio Department of Health Billables Project- Patient Survey

Background:  Proper access to immunizations is an important issue in Ohio’s communities. There has been an increase in both the number of vaccines recommended and vaccine cost, however the funding at the state level has remained static and Ohio is currently two-tiered for Rotavirus, Hepatitis A and HPV vaccines. Although delegation of authority has increased the number of children that can be immunized in the public sector, VFC’s narrowly defined underinsured category leaves children with high co-pays and high deductibles without proper access to the recommended vaccines. The Billables Project is seeking to increase reimbursement in the public sector through developing an action plan to bill private insurance for plan patients that receive immunization at a Local Health Department (LHD). This billing system will decrease the amount of funding needed to remove the two-tiered system in Ohio, and ultimately increase access to recommended vaccines for all children in Ohio.

Setting:  LHD immunization clinics, both internal and satellite.

Population:  Patients receiving immunizations at LHDs in Ohio.

Project Description:  Over a period of four months, twelve college interns administered a survey at LHD immunization clinics. The survey collected the following information about patients receiving immunization: age, zip code, previous use of the LHD, reason for using LHD, and insurance status (If privately insured, the insurance company, group number, contact information and co-pay information were requested). All patient surveys were mailed to the Ohio Department of Health central office and entered into a database for further analysis.  

Results/Lessons Learned:  Overall, 9563 surveys were collected and 44.6% of the patients were determined to have private insurance coverage. If reimbursement can be collected from the insurance companies of these patients there is potential to use those funds to increase in the amount of vaccines provided through Ohio’s LHDs. Ultimately this will protect more children from vaccine preventable diseases.