PDF(Pubmed)
Abstract：
UNASSIGNED: Effective from October 2023, federal law requires Medicaid programs to cover all recommended adult vaccines administered by physicians with no cost sharing for all eligibility groups. However, uniform coverage does not always translate to optimal uptake. Rather, other factors such as Medicaid reimbursement rates influence vaccine access and ultimately patient uptake. This study reviewed Medicaid policies to understand vaccine coverage and reimbursement, for both physicians and pharmacists, in all 50 U.S. states; Washington, DC; and Puerto Rico (collectively referred to as states).
UNASSIGNED: Between March and September 2022, the researchers reviewed states\' public Medicaid policies regarding adult vaccines, focusing on the service of injectable vaccine administration and 3 products: hepatitis A, 9-valent human papilloma virus, and 23-valent pneumococcal polysaccharide.
UNASSIGNED: Among 50 states with available data, 7 (14%) restricted Medicaid coverage for hepatitis A, 9-valent human papilloma virus, and/or 23-valent pneumococcal polysaccharide administered by physicians, and 15 (30%) did so for pharmacists. Median physician reimbursement rate was below the private sector rate for hepatitis A (89%) and 9-valent human papilloma virus (94%) but above the rate for 23-valent pneumococcal polysaccharide (108%). Median physician reimbursement for vaccine administration during an office visit was $11.86; the median pharmacist administration fee was $10.67.
UNASSIGNED: Although federal law now requires all state Medicaid programs to cover, without cost sharing, all recommended adult vaccines administered by physicians, equitable vaccine access may be hindered by state coverage restrictions for pharmacists and by relatively low reimbursement rates relative to Medicare and commercial coverage for both physicians and pharmacists.
UNASSIGNED: Between March and September 2022, the researchers reviewed states\' public Medicaid policies regarding adult vaccines, focusing on the service of injectable vaccine administration and 3 products: hepatitis A, 9-valent human papilloma virus, and 23-valent pneumococcal polysaccharide.
UNASSIGNED: Among 50 states with available data, 7 (14%) restricted Medicaid coverage for hepatitis A, 9-valent human papilloma virus, and/or 23-valent pneumococcal polysaccharide administered by physicians, and 15 (30%) did so for pharmacists. Median physician reimbursement rate was below the private sector rate for hepatitis A (89%) and 9-valent human papilloma virus (94%) but above the rate for 23-valent pneumococcal polysaccharide (108%). Median physician reimbursement for vaccine administration during an office visit was $11.86; the median pharmacist administration fee was $10.67.
UNASSIGNED: Although federal law now requires all state Medicaid programs to cover, without cost sharing, all recommended adult vaccines administered by physicians, equitable vaccine access may be hindered by state coverage restrictions for pharmacists and by relatively low reimbursement rates relative to Medicare and commercial coverage for both physicians and pharmacists.
摘要：
■自2023年10月起生效，联邦法律要求医疗补助计划涵盖由医生管理的所有推荐成人疫苗，所有资格组无需分摊费用。然而,均匀的覆盖率并不总是转化为最佳的吸收。相反，其他因素，如医疗补助报销率影响疫苗的获取和最终患者的摄取。这项研究回顾了医疗补助政策，以了解疫苗覆盖率和报销，对于医生和药剂师来说，在美国所有50个州；华盛顿，DC；和波多黎各（统称为各州）。
■在2022年3月至9月之间，研究人员审查了各州关于成人疫苗的公共医疗补助政策，专注于注射疫苗管理服务和3种产品：甲型肝炎，9价人乳头瘤病毒,和23价肺炎球菌多糖。
■在有可用数据的50个州中，7（14％）限制甲型肝炎的医疗补助覆盖范围，9价人乳头瘤病毒,和/或23价肺炎球菌多糖，和15（30％）这样做的药剂师。甲型肝炎（89％）和9价人乳头瘤病毒（94％）的中位值低于私营部门的报销率，但高于23价肺炎球菌多糖的报销率（108％）。在办公室就诊期间，医生对疫苗管理的平均报销额为11.86美元；药剂师管理费的中位数为10.67美元。
■尽管联邦法律现在要求所有州医疗补助计划都包括在内，没有费用分摊，所有推荐的由医生管理的成人疫苗，国家对药剂师的覆盖限制,以及相对于Medicare和医师和药剂师的商业覆盖而言相对较低的报销率,可能会阻碍疫苗的公平获取.
■在2022年3月至9月之间，研究人员审查了各州关于成人疫苗的公共医疗补助政策，专注于注射疫苗管理服务和3种产品：甲型肝炎，9价人乳头瘤病毒,和23价肺炎球菌多糖。
■在有可用数据的50个州中，7（14％）限制甲型肝炎的医疗补助覆盖范围，9价人乳头瘤病毒,和/或23价肺炎球菌多糖，和15（30％）这样做的药剂师。甲型肝炎（89％）和9价人乳头瘤病毒（94％）的中位值低于私营部门的报销率，但高于23价肺炎球菌多糖的报销率（108％）。在办公室就诊期间，医生对疫苗管理的平均报销额为11.86美元；药剂师管理费的中位数为10.67美元。
■尽管联邦法律现在要求所有州医疗补助计划都包括在内，没有费用分摊，所有推荐的由医生管理的成人疫苗，国家对药剂师的覆盖限制,以及相对于Medicare和医师和药剂师的商业覆盖而言相对较低的报销率,可能会阻碍疫苗的公平获取.
