MANAGED CARE ORGANIZATIONS AND PUBLIC-HEALTH - EXPLORING COLLABORATION ON ADOLESCENT IMMUNIZATIONS

Managed care organizations (MCOs) joined local and stare public health agencies in a pilot effort to improve hepatitis B immunization rates of adolescents in an urban and a suburban/rural school district. The p ilot also explored issues inherent in public and private collaboration on population health improvement. Local public health agencies provid ed links to schools in their communities, took the end in implementing school-based immunization programs, and provided health education mat erials. MCOs contributed financial support necessary for the project. The final cost per fully vaccinated student, not taking into account t he work group's planning and coordination time, was little more than t he catalog price of the vaccine alone. Managed care organizations face challenges that complicate their participation and funding of school- based vaccinations: 1) Limited data on health plans of participating s tudents complicate allocation of costs to each MCO; 2) Double-paying o ccurs for MCOs paying clinics a monthly, per-member rate that already includes adolescent immunizations; 3) When schools provide adolescent immunizations, MCOs lose the ''hook'' that draws adolescents to clinic s for comprehensive health services. When self-consenting is permitted schools can achieve a high consent and completion rates for multi-dos e adolescent immunizations such as hepatitis B. Ar the same time, MCOs have the responsibility to provide members with comprehensive care an d should continue to examine both internal modifications and external partnerships as opportunities to improve their services to adolescents .