• Unique data made possible through our cloud-based network reveals that some pediatric practices are not being sufficiently reimbursed for providing vaccinations. See the results ahead.

    • Using our cloud-based model, we were able to analyze payments for 158,983 charges from 1427 pediatricians, billed to 48 payers. For a list of vaccine trade names, click here.
    • After analyzing the data, we found that 47.2% of vaccine reimbursements were below the CDC-published direct cost plus minimum 17% indirect cost recommended by AAP.
    • Small practices were reimbursed below cost plus the 17% minimum indirect costs 45.1% of the time.
    • Small practices may be reimbursed for the full cost of vaccines less frequently than large practices due to their lack of bargaining power with payers.
    • Large practices were reimbursed below cost plus the 17% minimum indirect costs 31.7% of the time.
    • Large practices, which administer a higher volume of vaccines, have more bargaining power and are often able to secure a higher rate of reimbursement for the cost of vaccines.
  • Ready to learn more? Download our FREE WHITEPAPER when you contact us.

Introducing VaccineView

Inspired by PayerView®, our ground-breaking annual analysis of payer performance, VaccineView brings transparency to vaccine reimbursement.

Read press release

Why VaccineViewSM?

Bringing transparency to the vaccine reimbursement process.

Inspired by PayerView®, athenahealth's ground-breaking annual analysis of payer performance, VaccineView looks at vaccine reimbursement to pediatricians from a distribution of payers across the nation. The objective of VaccineView is to bring transparency to vaccine reimbursement where it is otherwise lacking.

A child receiving a shot from the family physician is a time-honored image in health care. Part of virtually everyone's experience in the US, it evokes the kind of health maintenance we expect from our physicians. Unfortunately, low and inconsistent vaccine reimbursement is creating financial difficulties for pediatricians and GPs who serve children and public health.

In addition to shouldering the direct costs for vaccines, physicians must also deal with indirect costs that include:

  • Personnel costs for ordering and inventory
  • Storage costs
  • Insurance against loss of the vaccine
  • Recovery of costs attributable to inventory shrinkage, wastage, and nonpayment
  • Lost opportunity costs

The VaccineView analysis found that when the estimated minimum indirect costs of providing vaccinations are factored in, vaccine reimbursements are very often below physicians' total costs.

Given that vaccinations represent a substantial portion of pediatricians' out-of-pocket expenses, this underpayment threatens to compromise the financial viability of pediatric practices, which could in turn have an impact on public health.

Interested in Learning More?

Download our FREE whitepaper detailing results from VaccineView when you
contact us.

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