Yes. Each state program is built to meet the needs of its stakeholders. There are various assessment methodologies, adult and children programs, and services that KidsVax® offers. KidsVax® customizes its services to fit each state’s specific needs.
Providers: Provider offices no longer need to order private vaccine and potentially face being reimbursed less than the actual cost of the vaccine. The assessments for vaccines are paid by the health insurer, so the provider no longer needs to finance vaccine inventory.
Payers: The cost of vaccines procured by the state’s department of health through the CDC VFC contract are significantly lower than privately procured vaccine. Hence, insurers pay less for needed vaccines.
State: Many state vaccine programs are subsidized by federal or state funds and are costly to run and maintain. Universal vaccine programs help remove the financial burden from the state.
The payers, which include insurers, health plans, and third-party administrators (TPA), providers, and the state health department as well as the public.
Assessment rates are determined by the state or by a non-profit organization tasked with assessment setting and ensuring adequate funds for vaccine purchases.
Is there a federal law that allows states to buy all ACIP recommended vaccines off the CDC contract?
Yes. In 1993, Congress passed the Vaccines for Children Program (VFC). Contained in the legislative language and further explained in the 103rd Congressional Record, Congress explicitly provided for state vaccine programs by stating that any state willing to provide vaccines to providers without cost for all children not already eligible through the VFC could purchase vaccines off the CDC VFC contract.
Yes. Through KV Foundation, we donate time on a limited basis to state teams that are exploring universal purchase options. Check out the Resources page for more information on implementing a universal purchase program.
Will creating a universal vaccine purchase program add labor costs to the state department of health?
No. Vaccine funding programs are administered by KidsVax®. The health department duties are minimal and not labor-intensive. Generally, any added costs will be fully reimbursed by the program.
No. But KidsVax® recommends keeping each state’s CDC program officer fully informed along the way.
No. Operating costs are built into the assessments. General operating costs generally decrease after the initial implementation phase. Further, most states include a modest reimbursement factor (typically in the 3-5% range) to reimbursement certain state costs associated with universal vaccine programs.
Universal vaccine purchase is used to describe programs that procure all recommended vaccines by the Advisory Committee on Immunization Practices (ACIP). Universal vaccine purchase enables the state health department to procure recommended vaccines and distribute them free of charge to private practices, clinics, hospitals, and other providers who administer vaccines to privately insured patients.
Universal purchase programs are funded through public-private partnerships. Health plans, insurance carriers, and third-party administrators cover all or a significant portion of vaccine costs for the privately insured through assessments.
They don’t. Children who are eligible for vaccines under the federally funded Vaccines for Children (VFC) program continue to receive those vaccines at no cost to doctors, clinics, and other providers. VFC status screening remains a federal requirement for each visit by a child.
There are many benefits to universal purchase programs including:
- Increase vaccine access.
- Stabilize vaccine funding.
- Lower healthcare costs.
- Establish benefit value incentive for physicians.
- Increase efficiency of vaccine ordering, tracking, delivery, and monitoring.
- Facilitate a multi-disciplinary board involvement to oversee process improvement, new vaccine review and implementation, financial transparency, and overall efficient operation.
Universal vaccine purchase programs are created by state legislatures. Creating a universal purchase program involves:
- Passing state legislation authorizing assessments on payers, including insurers and third-party administrators.
- Gathering the support of stakeholders (payers, providers, state health officials).
- Assembling a vaccine board (either dependent or independent) to govern, provide transparency in fund collection and assessment setting as well as set policy.
- Selecting an administrator to provide operations and communications.