Are you planning to stock both Gardasil® and Gardasil 9® in your vaccine refrigerator?

Merck has created a resource for practices who plan to stock both vaccines to help prevent potential mix-ups.  Since both vaccines should be stored the same way (refrigerated and protected from light), Merck created an additional way to distinguish the vaccines by manufacturing them with different colored vial caps – Gardasil® has a green cap and Gardasil 9® has a brown cap.  Visit Merck’s resources for complete details on Gardasil® handling and storage.

Did you know it is estimated that only 29.6% of older adolescents have received a booster dose of meningococcal vaccine, leaving approximately 7 million older adolescents under-vaccinated against meningococcal disease?

How will you help protect your patients from this potentially devastating disease?

Start by identifying your practice’s booster vaccination rate and then increasing it:
• Compare the number of adolescent patients in your practice versus the amount of meningococcal vaccine you order
• Comb your EMRs for under-vaccinated 16- to 18-year-old patients and flag these patients for follow-up
• Implement a protocol to check every older adolescent’s chart and flag those who have not received a booster dose

Once you’ve established your practice’s booster vaccination rate, it is important that you set a goal and share the information with your staff. Remind them to talk to patients about meningococcal disease and to vaccinate at every opportunity. Don’t forget that sick visits are often a great opportunity to “catch” adolescents who don’t come in for well visits as often as younger children.

In 2010, the ACIP recommended that adolescents receive 2 doses of meningococcal vaccine: the first at 11 to 12 years of age and the second at 16 years of age. The second dose is recommended because at a critical time, immunity to meningococcal disease may wane: studies have shown that protection provided by the primary vaccination given at 11 to 12 years of age decreases over time. In fact, approximately 50% of older adolescents may be under-protected against meningococcal disease 5 years after primary vaccination—the same time they enter their peak period of risk for this disease.

References: 1. Centers for Disease Control and Prevention (CDC). Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2013;62(RR-2):1-28. 2. CDC. Updated recommendations for use of meningococcal conjugate vaccines—Advisory Committee on Immunization Practices (ACIP), 2010. MMWR. 2011;60(3):72-76. 3. CDC. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2013. MMWR. 2014;63(29):625-633. 4. Sanofi Pasteur Inc. Data on file (2nd dose immunization rates), April 2013. MKT26442.

Considering a backup generator for your vaccine refrigerators and freezers in case of a power outage? That’s great, but it only addresses one potential issue that can impact vaccine storage temperatures – complete loss of power.

Consider hooking up a remote temperature monitoring system that can alert you to temperature excursions for any reason, like a refrigerator door being left open or an equipment malfunction.  Monitoring systems can be setup through certain office alarm systems or purchased independently.  Two companies who specialize in this area (Temperature Guard and Sensaphone) make systems that can monitor multiple storage units and call or text several phone numbers until there is a response.  The ability to monitor your vaccine storage equipment while you are away from the office is not only an investment in protecting your vaccines, it is also an investment in your peace of mind!

Does your practice have an emergency plan that addresses vaccine storage equipment in case of an emergency?

Summertime means longer days, no school, backyard grilling, and vacations to many people.  Unfortunately, summer can also mean increased likelihood of severe weather that can lead to power outages and wreak havoc on your practice.  Loss of vaccine inventory due to an equipment malfunction or loss of power can be very expensive!  CPP has pulled together various resources from the CDC and the AAP to help you establish protocols so your practice can be prepared in the event of such a disaster and minimize loss should such an event occur.   It is important to think about what to do in the case of a power failure, create a plan to maintain appropriate temperatures and establish contingency plans to transport vaccines safely in the case of prolonged power outages before disaster strikes!

The CDC and the VFC Program also provide great resources to assist you.

Unsure of insurance coverage for new vaccines? Sanofi Pasteur and Merck have great resources to help!

Sanofi Pasteur and Merck have each launched a newly approved vaccine in the last six months.  The biggest question on the minds of many providers is if payers are adequately covering the cost of these vaccines.  Both Sanofi Pasteur and Merck offer great resources around billing and coding as well as a way to check and see if your local payers cover these new vaccines.

SANOFI PASTEUR
Quadracel® Billing & Coding Guide
Reimbursement Support Service (RSS) Hotline – 1-800 VACCINE (1-800-822-2463) and choose the RSS prompt.

MERCK
Gardasil 9® Billing & Coding Guide
Plan Specific Coverage Informational Tool

Family Physician, Dr. Andrew Loehr, shares best practices as it relates to the business of providing in-office immunizations.

The March/April 2015 edition of Family Practice Management highlights an article entitled Immunizations: How to Protect Patients and the Bottom Line  (http://www.aafp.org/fpm/2015/0300/p24.html).  Dr. Loehr, owner of a private family medicine practice and the AAFP’s liaison to the ACIP shares his wisdom around:

• Not paying too much for your vaccines
• Properly coding for all of the services provided during vaccine administration
• Making sure you are adequately reimbursed for those services

Taking advantage of manufacturer specials and prompt pay discounts along with paying with a credit card with cash back options resulted in even more cash flow to his practice!

CPP has also compiled best practices from other CPP members and leading vaccinators across the country to challenge you to identify vaccine-related waste in your practice (http://www.cppchallenge.com).  You can access helpful financial tools (http://www.cppdocs.org/resources-detail.php?id=4) that assist your practice in eliminating this waste including billing & coding webinars, vaccine coding cheat sheets and much more!

The CDC updates the vaccine price list to include new meningococcal B and HPV vaccines.

Practices should use the Private Sector Cost/Dose column as a guideline when negotiating payer contracts.  The AAP business case for administering vaccines recommends negotiating reimbursement for the cost of the vaccine that floats 17%-28% above the CDC private sector list price.  The floating rate helps ensure your reimbursement rates adjust when catalog prices are increased by the manufacturers and the additional percentage accounts for the indirect costs of ordering, storing and managing vaccines.

Make the most of your electronic medical record system.

Why does an EHR “fail” in one practice but succeed at another?
What do those successful practices know that the challenged ones do not?
And what can you do about it now, after you’ve already chosen your EHR (or had it chosen for you)?

Chip Hart from Physician’s Computer Company lends his expertise to share ways you can optimize the use of your EMR, including how it can help improve immunization rates at your practice.

Comment on this post and share with other CPP Members how your practice was able to improve overall patient care by letting your EMR system work for you.

Access additional resources to help you make the most of your EMR including:
• tips
• user reviews from members of the AAP
• AHRQ requirements for Children’s Electronic Health Records

The CDC has published updated materials to assist providers in speaking with parents about the MMR vaccine.

Due to the increased number of measles cases in the United States so far in 2015, pediatric providers are fielding more questions from patient families about the safety and efficacy of the MMR vaccine.   Medical practices can utilize these updated materials to help with parent conversations and stay up to date on the status of the current measles outbreak.

Do you immunize adults? Do you need help implementing the new pneumococcal vaccine recommendations?

The California Department of Public Health, Immunization Branch has developed a Pneumococcal Vaccine Timing clinical reference tool.
The chart summarizes the latest adult pneumococcal vaccine (PCV13 and PPSV23) recommendations for both:
• All adults age 65 and over (both vaccines now covered by Medicare Part B)
• Adults 19-64 with certain underlying conditions