Adults seeking access to and coverage for vaccines encounter a confusing health care system that presents multiple barriers, including lack of information about recommended vaccines, financial hurdles, as well as technological and logistical obstacles. AVAC is working towards legislative and regulatory solutions that will strengthen and enhance access to and utilization of adult immunization services across the health care system. Our priorities include:
AVAC is committed to improving reporting of adult vaccinations to state immunization registries and encouraging greater utilization of health information technology to track adult vaccination status and improve patient outcomes and care.
Advancements in health information technology create multiple opportunities for greater access and utilization of immunizations among adults. Technology has the power to inform providers about recommended vaccines for the adult population. It can also foster providers’ ability to receive and send information about patients’ immunization status.
Immunization information systems (IIS), also known as registries, are confidential, population-based, computerized systems that record all immunization doses administered by participating providers to persons residing within a given area. IIS systems create a comprehensive, consolidated immunization record for individuals, which can then be used by providers to determine which recommended vaccines may be appropriate for the patient. At the population level, an IIS can also provide aggregate data on immunizations for use in surveillance and program operations, and in guiding public health action with the goals of improving vaccination rates and reducing vaccine-preventable disease.
Quality reporting measures are an increasingly important tool to track progress and desired outcomes in terms of preventive services benchmarks. Monitoring and reporting of offered and administered immunizations helps to ensure that the range of available immunizations remain a priority and in the forefront of clinical care standards.
Reducing the number of missed immunization opportunities is imperative to improving health and reducing the burden of vaccine preventable disease.
Developing, testing, and integrating additional ACIP-recommended adult immunizations as quality measures and incentive benchmarks under Medicare, Medicaid, and private insurance would help drive utilization and improve patient access to these low-cost preventive services.
Despite the health benefits that result from implementation of ACIP recommendations, vaccines have been consistently underutilized in the adult population and lag far behind the Healthy People 2020 goals. These disparities are even greater when looking at-risk populations – including seniors, communities of color, limited English proficient persons, and people with chronic illness.
Though the childhood vaccination program in the United States has been largely successful at reducing or eliminating racial and ethnic disparities in vaccination coverage, minority communities and vulnerable adult populations continue to experience significant disparities in adult immunization rates. For example, African American, Asian, andLatino adults receive recommended vaccinations at rates far below those of whites for every adult-recommended vaccines.
At risk populations, including the frail elderly and pregnant women, also lag behind Healthy People 2020 adult immunization goals, yet are particularly vulnerable to the adverse health consequences of vaccine preventable illness. Barriers to access through public health programs, such as significant beneficiary cost sharing under Medicare Part D and variations in immunization coverage under state Medicaid programs hinder public health and provider efforts to improve rates among these subgroups.
Targeted efforts are needed to address the specific challenges that vulnerable groups face in order to close the immunization gap and improve adult immunization coverage rates overall.
RE: 2020 Medicare Advantage and Part D Advance Notice and Draft Call Letter (CMS-2017-0163)
March 1, 2019 Seema Verma Administrator Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 RE: 2020 Medicare Advantage and Part D Advance Notice and Draft Call Letter (CMS-2017- 0163) Dear Administrator Verma: As participants in the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS) ...
Re: Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for Healthy People 2030
January 17, 2019 Don Wright, MD, MPH, FAAFP Deputy Assistant Secretary for Health Office of Disease Prevention and Health Promotion Department of Health and Human Services Tower Building 1101 Wootton Parkway, Suite LL100 Rockville, MD 20852 Re: Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for Healthy People 2030 Dear Dr. Wright: The Adult Vaccine Access Coalition ...
RE: CMS-1689-P Medicare and Medicaid Programs; CY 2019 Home Health Prospective Payment System Rate Update and CY 2020 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; Home Infusion Therapy Requirements
August 31, 2018 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1689-P P.O. Box 8013, Baltimore, MD 21244-8013 RE: CMS-1689-P Medicare and Medicaid Programs; CY 2019 Home Health Prospective Payment System Rate Update and CY 2020 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; Home Infusion Therapy Requirements To ...
RE: CMS–1694–P Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019
June 26,2018 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1688-P P.O. Box 8016 Baltimore, MD 21244-8016 RE: CMS–1694–P Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2019 To Whom It May Concern: As participants in the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to comment on the Medicare ...
Letter to Chairmen Cole and Ranking Member DeLauro
March 15, 2018 The Honorable Tom Cole Chairman House Labor, Health and Human Services, Education, and Related Agencies Subcommittee 2358B Rayburn House Office Building Washington, DC 20515 The Honorable Rosa DeLauro Ranking Member House Labor, Health and Human Services, Education, and Related Agencies Subcommittee 2413 Rayburn House Office Building Washington, DC 20515 Dear Chairmen Cole and Ranking Member DeLauro, As ...