Frequently Asked Questions
Can a universal program be customized to tailor specific state needs?
Yes. Each state program is different depending on the needs of the stakeholders. There are various assessment methodologies, adult and children programs, and services that KidsVax® offers uniquely designed to fit a state’s specific needs.
How can a universal vaccine purchase program save my state money?
- 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 subsidize vaccine costs.
- 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, and insurers pay less for the vaccine.
- 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.
Who are the stakeholders of a universal vaccine purchase program?
The payers, which include insurers, health plans, and third party administrators (TPA), providers, and the state health department.
How are payers assessed for vaccine costs?
Assessment rates are determined by the state or by a non-profit organization tasked with set-up to establish assessment setting protocols 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.
Can KidsVax® staff help our state set up a universal purchase program?
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 my state need to obtain CDC’s permission to create a universal purchase program?
No. But Kidsvax® recomends keeping each states's CDC program officer fully informed along the way.
Are state general funds needed to operate a universal vaccine purchase program?
No. Operating costs are built into the assessment costs. 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 cost associated with universal vaccine ready programs.
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.
What does “universal vaccine purchase” mean?
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 that administer vaccines to privately insured patients.
How are universal purchase programs funded?
Universal purchase programs are funded through public-private partnerships. Health plans, insurance carriers, and third-party administrators cover all or a significant portion of immunization for the privately insured through assessments.
How do universal purchase programs affect federally funded vaccines?
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 young patient.
What are the benefits of universal purchase programs?
There are many benefits to universal purchase programs including:
• Increase vaccine access
• Stabilize vaccine funding source
• Lower healthcare costs
• Establishes benefit value incentive for physicians
• Increase efficiency of vaccine ordering, tracking, delivery, and monitoring
• Facilitated by multi-disciplinary board to help aid: process improvement, new vaccine review and implementation, financial transparency, and overall efficient operation.
How is a universal purchase program created?
Universal vaccine purchase programs are created by state legislatures.
Creating a universal purchase program involves:
1. Passing state legislation authorizing assessments on payers and insurers.
2. Gathering the support of stakeholders (payers, providers, state health officials).
3. Assembling a vaccine board (either dependent or independent) is established to govern, provide transparency in fund collection and assessment setting as well as set policy.
4. Selecting an administrator to provide operations and oversight.