“WHAT YOU NEED TO KNOW ABOUT IMMUNIZING YOUR ADULT PATIENTS”
(WEB EXCLUSIVE, MAY 2009)
I enjoyed the article on the obstetrician-gynecologist’s role in adult immunization. One element that is frequently not considered is the cost of immunization in many settings in which it is provided. Immunizations that are provided during pregnancy, while the woman is in the hospital, or during postpartum visits to the physician’s office are unlikely to be reimbursed by Medicaid or insurers, as global fees are paid.
In 2008, our hospital’s OB-Peds inpatient unit provided more than $150,000 of unreimbursed immunizations (against the flu; measles, mumps, and rubella; Tdap for new mothers; and hepatitis B, mostly for newborns). At another hospital of which I am aware, physicians order the first human papillomavirus vaccine for postpartum patients who desire immunization.
There is no doubt in my mind that immunization represents the best investment in health care. Do you think the new health-care reform efforts might include reimbursement for immunizations regardless of where they are provided?
Charles W. Schauberger, MD, MS
Cedar Rapids, Iowa