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Creating a Healthier Future: Establishing and Expanding Immunization Programs
June 4, 2024
Immunizations save 2.5 million lives worldwide each year. The World Health Organization reports that although pharmacists who act as immunizers and vaccination advocates positively impact immunization rates, the experts also say vaccination hesitancy is a top 10 global health threat.
The fact that pharmacies represent the most accessible healthcare facility in America means that pharmacists have a duty to help ensure their communities are vaccinated. Pharmacists play three essential roles related to immunization: they can be 1) facilitators who host others who vaccinate, 2) advocators who educate and motivate patients, and 3) immunizers who vaccinate patients.
Pharmacists have some level of vaccination authority in all 50 states, making now a prime time to create or grow your immunization program.
The Importance of Providing Vaccinations in Pharmacies
Nine out of ten people in the United States live within five miles of a pharmacy and 70% of vaccinating pharmacies are in neighborhoods with moderate-to-high social vulnerability. The convenience and accessibility of pharmacies are undeniable.
In addition to being accessible and convenient, most Americans consider pharmacists to be trusted healthcare providers. Nearly 90% of pharmacy patients say they are interested in receiving care and guidance from their pharmacists and almost 70% say they would go to their neighborhood pharmacy for a vaccination before going to their primary care physician’s office.
Pharmacies are instrumental in addressing healthcare deserts, and pharmacists are highly regarded for their ability to provide high-quality care. Offering vaccination services in your pharmacy is a sure way to impact community health.
Laying the Foundation for a Strong Immunization Program
Pursuing the goal of including or ramping up vaccination services at your pharmacy requires in-depth insights and know-how. Here are three key steps every pharmacy should take:
1. Demystify Health Plan Contracts
The initial stage of providing immunizations to your community involves establishing the necessary arrangements for receiving payment for your services.
- Familiarize yourself with the intricacies of health plans, Medicare, and Medicaid to optimize reimbursement for immunization services.
- Contact commercial payors and negotiate agreements that outline the terms and conditions for reimbursement.
- For Medicaid, you should contact your state’s Medicaid agency to understand the requirements for reimbursement.
- Reduce administrative barriers by partnering with a trustworthy solution provider to manage your practitioner renewals for government and private payors.
2. Make Sure Shots are Safe and Affordable
Ensuring every patient entering your facility meets clinical and financial eligibility criteria is essential.
- Uphold the highest standards of care by diligently evaluating clinical eligibility to protect your patients from adverse reactions.
- Stay informed about the latest guidelines from authoritative bodies like the Advisory Committee on Immunization Practices (ACIP).
- Consider using a technology that automates the clinical and financial identification process, such as OmniSYS CareALERTS™.
3. Get Documentation Done Right
You must be prepared to meticulously record and capture patient details, vaccine specifics, and any adverse reactions.
- Proper documentation is vital to ensure reimbursement.
- Detailed records substantiate your services and are necessary for accurate coding and billing.
- Utilizing a robust electronic health record (EHR) system purpose-built for pharmacies can streamline your documentation and ensure accuracy and compliance with regulations.
Creating a Healthier Future: Establishing and Expanding Immunization Programs
Understanding and establishing payor relationships, being prepared to evaluate a patient’s clinical and financial eligibility, and ensuring your documentation processes are in order serve as necessary steps to launch or improve your vaccination program. However, instituting an effective vaccination program also involves promoting immunization services, creating a space to treat patients, reporting, and more.
OmniSYS is committed to developing tools supporting pharmacists and their communities. Explore our latest playbook, Boost Your Immunization Program for a Healthier Future, to learn more about establishing an effective vaccination program.