For 30 years, Alaska maintained a universal vaccine program, where federal funding paid for all the standard shots. But in 2011, the money started drying up, leaving only the most vulnerable populations covered.
Now, universal access to vaccines may be back, with a law that uses the state as a broker between insurance providers and pharmaceutical companies to get a bulk rate discount. At the bill signing this week, State Sen. Cathy Giessel said the idea is to make sure “all Alaskans, insured and uninsured, had access to vaccines.” On top of increasing access to vaccines, health care providers expect the law to save them time and money.
Dr. Susan Beesley is making the rounds through the offices of the Anchorage Pediatric Group. Plenty of nurses stop to say hello, and one mentions giving shots. Beesley has practiced there for five years. But right now, she’s not on the clock.
“Today, I’m here as a mom. I’m here for my two-month well-child check with my daughter Robin Beesley.”
Her baby will be getting immunized against whooping cough and tetanus, diphtheria and rotavirus.
“So, today she’s getting one oral vaccine and three shots,” says Beesley.
While getting shots may be a new thing for baby Robin, immunizations are a huge part of what the Anchorage Pediatric Group does. Beesley alone sees about 20 kids every week who get vaccines.
When Beesley first moved to Alaska in 2009, the state still had universal vaccine coverage. It didn’t matter if you were a kid, an adult, insured, or uninsured: If you were getting an ordinary vaccination, the federal government was probably footing the bill.
“Slowly over the past five years, we’ve lost that. And it’s sort of been a step-wise progression from having universal coverage to then just a couple of shots not covered universally, and then slowly, all of them have been sort of changed over to a two-tier system.”
Public funding covers about a third of the shots administered by Anchorage Pediatric Group. The rest are billed to the insurance companies or to the patient.
To avoid a billing mess, the group has to make sure the vaccines are stored according to who pays for them, even though the shots are identical. That means keeping the same exact vaccine in separate bins, in refrigeration units divided by Plexiglas. Some clinics have to spend extra money on entirely different refrigerators for different types of patients.
And no matter how organized a group is, Beesley says there are occasional mix-ups when it comes to distributing the public supply and the private one.
“Sometimes, you give accidentally private stock to a child that you later find out may have had a private insurance, but lost it, and now they’re on Medicaid,” says Beesley. “You can end up eating the cost as the practice for that vaccine.”
Those vaccines aren’t cheap. While we’re waiting for baby Robin’s appointment, Beesley grabs practice administrator Brice Alexander to explain just how much money their group spends on them.
“The cost of the vaccines some of them are upwards of $200 just for the serum itself,” says Alexander.
Alexander adds that the Anchorage Pediatric Group fronts $40,000 a month on vaccines for patients who don’t qualify for the public immunization program, before passing that cost on through patient bills.
But starting next January, the group won’t have to do that. The State of Alaska will be implementing a new system where they act as a buyer for vaccines. They’ll assess insurance companies and private practices a fee, and then use that money to buy vaccines for providers at a serious discount. In states with similar programs, access to vaccines has increased, making disease outbreaks less likely. Providers, patients, and insurance companies have saved millions of dollars.
The new system also means hospitals and clinics won’t have to segregate their vaccines anymore or bill them differently. Alexander expects that to be a time-saver.
“Not having to worry about explaining to patients why they have such a huge bill, it’s much easier to focus on, ‘Yeah, you showed up for the visit. Here’s your bill for the visit, and everything else is covered,” says Alexander.
Beesley also welcomes the change.
“The bottom line is just that it’s such an important preventive service, and we want to be able to provide exactly the same to all of our patients,” says Beesley.
While the new system should make work easier for Beesley and her colleagues, the actual shots themselves aren’t as much fun for Robin. She cries a little, but quickly stops after being patched up with some sparkly Band-Aids and being returned to her parents.
After a few more minutes, Robin is ready to go until the next round.