Health care reform may have implications for vaccine providers

VANCOUVER — Collaboration at both the state and federal levels will be key to implementing some of the changes in the health care reform bill, according to a speaker here at the 2010 Pediatric Academic Societies Annual Meeting.

“Health care reform is going to be a work in progress, and there will be major challenges for us all if the promise of health care reform is going to be transformed into a reality of improving the lives of children and vaccination rates,” Stephen Berman, MD, of the University of Colorado Denver, said during a presentation.

Berman noted that advantages of the health care bill include its immediate implementation within 90 days of passing for many child insurance reform provisions and its focus on preventive care as first dollar coverage. However, he said, issues like undervaccination and reimbursement will likely continue to be debated.

“Battles will be waged to ensure that this health insurance reform piece seriously considers the issue of underinsurance for vaccines and deals with vaccine issues,” Berman said.

Health care reform will also affect Medicaid and the State Children’s Health Insurance Program, according to Berman. Vaccine reimbursement issues have also been discussed as part of the Medicaid changes. The flexible language that discusses reimbursement allows for changes as new codes and vaccines come on line without the need for new legislation.

“Also, both in 2013 and 2014, Medicaid services, hopefully for pediatric subspecialists as well as pediatric primary care … will go to at least Medicare rates and vaccine administration codes would be increased substantially to Medicare rates,” said Berman.

Berman said that all of these elements contained in the health care bill have the potential to change how children receive vaccines. Many of the financial barriers to vaccination may be dealt with through reform, he explained, but the plan is still in a developmental phase.

“One caution, especially for academic pediatricians, is how the state and federal governments will implement this plan in a time of fiscal austerity when state and federal agencies are undermanned in terms of implementation work,” said Berman. “It will be important for those of us in academic medicine to forge collaborative relationships at both the state and local levels to help develop implementation plans.” – by Melissa Foster

For more information:

Berman S. #1630. Presented at: 2010 Pediatric Academic Societies Annual Meeting; May 1-4, 2010; Vancouver, British Columbia.

Follow the PediatricSuperSite.com on Twitter.