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Managing Costs

Updated 10/2015

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While there are many costs associated with purchasing and administering vaccines, there are ways for pediatric offices to manage these costs in order to cover overhead.

There are various ways to purchase vaccines. They include:

  • Standard programs
    Direct purchasing access is offered by all major vaccine manufacturers. This may be an easy way to purchase vaccines, but often will not provide the best price.

  • Physician buying groups (PBGs)- see Table 1
    These offer group access to 1 or 2 major vaccine manufacturers. Competing vaccine companies will not be in a PBG together. A major benefit of the PBG model is discounts—the purchaser may receive up-front discounts based on contract or quarterly rebates based on use.    

  • Group purchasing organizations (GPOs)
    These are typically operated by hospital-affiliated purchasing groups. Although pricing models are not as favorable as in PBGs, purchasers are not limited to certain vaccine manufacturers or products.

Vaccine Administration

There may be ways to manage the costs of vaccine administration.

  • Choosing Staff to Immunize
    Each state has its own rules as to who is qualified to administer immunizations and it is important to be familiar with those regulations. RN's and LPN's, MA's, and, in some offices, the physician or mid-level practiti​oner will administer them. That individual will need to evaluate the appropriate written order, carefully draw up the vaccines with sterile technique, document the administration in the paper or electronic health record, and provide the caretaker with the opportunity to record the vaccine in a personal record or identified on billing stat​ement (visit the vaccine administration​  page for more information).  Most practices have found that validation by a second staff person increases quality and billing accuracy.  

    All providers must be properly trained and familiar with the potential side effects from each of the vaccines. Most group practices have found that medical assistants are the most cost effective providers to administer vaccines. Registered nurses are best utilized to sup​​ervise other employees, provide medical triage, and to give medical advice. Generally, the employee who is able to perform the work at the lowest price should. For example, do not use a pediatrician when an RN is just as able to do the work.

    Optimum vaccine administration will be achieved when all necessary immunizations are ordered and discussed by the physician, administ​​ered by an efficient medical assistant, and documented and billed at an appropriate vaccine cost and administrative fee.

  • Maximize Opportunities

    Vaccines should be administered according to the joint guidelines developed by the Advisory Committee on Immunization​​ Practices  (ACIP) and AAP. It is important to note that well visits are the usual occasion to provide appropriate immunizations, but that any office encounter provides an opportunity to update a child's protection. Ordinary sick visits should not be a "missed opportunity" for vaccination. Office staff may check for missing immunizations when making appointments or triaging the patient in the office.​

    A general busine​​​ss principle to follow is that the more one can accomplish at a single visit, and the more one can charge, achieves better compliance with pay for performance and achieves fewer visits that ultimately decrease office overhead.

  • Utilizing combination vaccines with appropriate coding

    Using combination vaccines, and coding the appropriate vaccine administration fee for each component of the vaccine, allows practitio​ners to provide combination vaccines without a financial loss compared to vaccinating with individual doses. Visit the coding page for more information.​

Deciding on a Group:

Below are some questions to ask when deciding whether a specific PBG or GPO is right for you:

  • Which manufacturer(s) are included in the program? Under what circumstances can I purchase outside the plan? What are the purchasing compliance requirements?
    • Based on this contract, how will my usual vaccine regimen be affected? Would I need to start administering different vaccines? How will this affect office education or nurses' time?
    • If I have to change the type of vaccine I order, is the change worth it? Is there another option with similar pricing that would allow me to order what I currently use?
  • Is there a cost to participate? What is the length of my contract commitment? Does this plan provide rebates to its participants?
  • Is pricing tied to volume? Do all participants have the same terms?
    • Does placing large- or small-volume orders allow me to receive the optimal discount?
    • How do your discounts compare with my current pricing?
    • Can I take advantage of additional manufacturer discounts through this program?
    • How frequently am I allowed to order? What is the process to order vaccines? Is a code needed to order online? Is there an administrator to call?
    • Can the practice order whenever it wants? Is there a limit to how many orders can be placed in a given time? What is the process for ordering (e.g., phone, online)?
    • Can I reduce my practice's time and resources spent on ordering vaccines so that maximum discounts are still achieved? Does the program eliminate the need to order strategically to achieve best pricing?
  • What customer-service resources are in place to answer our questions and provide supply assistance? How long has the plan been in business and how many doctors does it work with? (You can also ask your manufacturer representatives for their views of the program.)
  • Are there geographic limitations to participation?
  • What value-added services (eg, payment support, office supplies) does the plan provide?

Physicians have reported working with the following buying groups or group purchasing organizations in the past:

Table 1. Physician Buying Groups and Group Purchasing Organizations

Group Name Items included in Group Membership/Fee Requirements Contact Information
AAP Affinity Program - Child Health Advantage Vaccines
Clinical supplies
Pharmacueticals
Business services
AAP Member.Membership Coordinator
advantage@childrenshospital.org
913-262-1436
www.childhealthadvantage.com
Atlantic Health Partners

Vaccines
Office Supplies
Medical Supplies
Patient Recall Program
Discounts for Vaccine Refrigerator/ Freezers

None.Jeff Winokur
jwinokur@atlantichealthpartners.com
800-741-2044
www.atlantichealthpartners.com
CASA Physicians AllianceVaccines
Medical and Surgical Supplies
Office Supplies
Rebate Program
No fees.
Physicians and physician groups in the United States may participate.​

Andi Dixon or Shari Smith info@casaalliance.net 
866-434-9974
www.casaalliance.net

CCPA Purchasing PartnersVaccines, Medical Supplies, Computer Hardware, Commercial Tenant Representation, Document Storage/Scanning/Shredding, Electronic Payment Services, Insurance Brokerage, IT Support, Medical Waste Disposal, Office Equipment/Supplies/Furniture, Payroll Services, Temporary Staffing

None

Nationwide

Administrative Award for Members

Paresh Patel
papatel@ccpapp.org​
312-227-7436​
www.ccpapp.org​
Children's National Health Network (CNHN) Vaccines
Office Supplies
Medical Supplies
No fees. Must be a member of CNHN to access contracts, programs, & services. Donnita Pickett
dpickett@childrensnational.org
202-476-2727
http://www.childrensnational.org
Children's Practicing Pediatricians, IncVaccines
Office Supplies
Medical/Surgical Supplies
No feesChildren's Practicing Pediatricians, Inc.
cpp@nationwidechildrens.org
614-722-2145
www.cppdocs.org
Cumberland Pediatric FoundationVaccines
Medical Supplies
No fees.
May be required to maintain certain benchmarks
Practices must give 30 day notice to opt out of  agreement.
Lora Harnack
lora.a.harnack@vanderbilt.edu
615-936-6053
www.cumberlandpediatric.org
Fair Advantage ConsortiumVaccines
Medical Supplies
 Robin Riggs
rriggs@fairadvantage.com
256-265-2464
www.fairadvantageconsortium.com
Integrated Physician Solutions (IPS)

Vaccines
Office Supplies
Medical Supplies
Malpractice Insurance

No fees.Lynne Sherman
lsherman@ips-usa.com
678-832-1824
http://vaccines.ips-usa.com
KelsonVaccinesUnknown.866-820-4898
http://www.kelsoncorp.com/vaccine.php
Main Street Vaccines

Vaccines
Medical Supplies
Surgical Supplies
Vaccine Refrigerators
Rebates

No fees.

Allen Menkin, MD, MS, FAAP President
drmenkin@mainstreetvacs.com

Kate Beggerow, Administrator
administrator@mainstreetvacs.com
(888) HUB-MAINSTREET
(888)482-6246
http://www.mainstreetvacs.com/

Medical Practice Purchasing Group (MPPG)

Vaccines
Office Supplies
Medical Supplies
20
more Contracts

No fees.​
Loyalty payments for members in good standing.

Brian K. Greenberg, MD, FAAP
818-332-7057

Leslie Fuchs 
leslief@mppg.net
714-469-5296
www.mppg.net

National Physician CareVaccines
Medical Supplies
Office Administrative Services
CHADIS
Internet and Phone Service
Private practice physicians and clinics.
No fees for private practice physicians.
Richard Miles
RLMiles@nationalphysiciancare.com
877-598-3286
www.nationalphysiciancare.com
National Discount Vaccine AllianceVaccines
Office Supplies
Medical Supplies
No fees.Kathleen Cain, MD, FAAP
kcain@nationaldiscountvacinealliance.com

www.nationaldiscountvaccinealliance.com
Northampton Area PediatricsVaccines
Office Supplies
Medical Supplies
AAP membership.Cindy Mayo
cmayo@napeds.com
413-584-8700
www.napeds.com
Pediatric Alliance Vaccines Medical Supplies

No membership fee. Virginia

Dr Richard Grossberg
rgrossberg@pediatric-alliance.com
Richard Lander
rlempg@gmail.com

www.pediatric-alliance.com

Pediatric Federation LLCVaccines
Office Supplies
Medical Supplies
No fees.
Nationwide.

Kathy Chebib
Kathy@pediafed.com
855-733-4233 x81
www.pediafed.com
https://pediafeed.com/vaccine-group-purchasing-organization

Peds PalVaccines
Office Supplies
Medical Supplies
None. pedspal@cookchildrens.org
877-923-2233
http://www.pedspal.org/contact.html  
Physicians' Alliance of America, Inc.

Vaccines
Vaccines Rebate Program
IUDs
Pharmaceuticals
Malpractice Insurance
Office Supplies
Medical Waste Removal 

No membership fees.

Private practices of all sizes and specialties in the United States are eligible. 
Heather McKelton
info@physall.com
1-866-348-9780
www.physiciansalliance.com
Primary Care AllianceVaccines
Medical Supplies
Any physician or physician group in the United States may participate. No feesAmy Dahl
adahl@primarycarealliance.com
866-470-0090
www.primarycarealliance.com

River Valley Pediatricians, Inc. (RVPI)

 

Vaccines
Office Supplies
Medical Supplies
Annual fee.
Must be community-based physician in the metropolitan area of Cincinnati, OH.
Ed Freeman
edward@rvpi.com
513-475-6084
www.rvpi.com
Southern California Children's Health NetworkVaccinesNo fees

Robert Kaplan
rrkaplan@ix.netcom.com
Angela Deanda
adeanda@isynermed.com
213-406-2711
​​www.isynermed.com

 

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