The Business of Pediatrics

Influenza vaccination makes sense for everyone

Influenza strikes in the United States every year, and perhaps that explains the indifference some physicians feel about immunizing their patients against the flu. It is easy to forget the devastating impact influenza can have on some patients. Luckily, the devastation can be mitigated by immunizing your patients.

Influenza has struck in the area where I practice. Both of the pediatric ICUs here have hospitalized very sick patients due to influenza. Our infectious disease consultants have urged us to continue vaccinating through March. Our work in helping our patients is far from over.

Richard Lander, MD 

Richard Lander

Before the influenza season began, physicians had been told to get ready for a bad season. With this in mind, my practice started vaccinating during the summer as soon as our influenza vaccines arrived. We gave it to the kids as they came in for their well appointments, we reached out to our high-risk patients (asthmatics, immunocompromised patients and cardiac patients), and we organized influenza parties, which assembled large numbers of patients to receive influenza vaccines at the same times. 

Some practices designated Saturdays or Sundays for immunizations, whereas others delineated specific times during the day or night for doctors, nurses and certified medical assistants dedicated specifically to give influenza vaccines intramuscular or nasally. These visits did not allow for discussions about the child’s 5-year history of encopresis or behavioral problems. We all hope to be effective in reaching large numbers of patients.

It is undeniable that vaccinating against influenza is good for patients. As luck would have it, vaccinating against influenza is good for the financial health of your practice as well. For example, let’s calculate monies generated for administering influenza vaccine for a doctor with a panel of 2,000 patients. We’ll be conservative and consider that only 1,000 patients will get their influenza vaccine in your office. Some of the 1,000 not receiving the vaccine in your office might be infants younger than 6 months of age and not eligible for the vaccine, and some patients will go to retail-based clinics or refuse the vaccine.

I know you are all financially savvy and you have purchased influenza vaccines at the lowest possible price. This would be from a group purchasing organization or directly from the manufacturer. The fee you receive has been set by your contract with each managed care organization and you are seeing a 10% to 25% profit. If your practice purchased the vaccine at approximately $10, the profit on these 1,000 patients will range from $1,000 to $2,500.

Additionally, you are receiving a vaccine administration fee, which should range from $14 to $30. This amounts to $14,000 to $30,000 for the 1,000 patients. Furthermore, in my practice, we do not vaccinate if a patient has not received a well visit in the last 12 months. If 100 patients who call for a flu shot ending up scheduling a well visit, you should be generating an additional $10,000. Bottom line: $25,000 to $42,500, which is not bad!

Influenza can be devastating. Offering influenza vaccines to your patients is good for their health. It is good for the whole community. Giving influenza vaccine is also good for the financial health of your practice.

Richard Lander, MD, is a pediatrician in private practice in northern New Jersey and is a member of the Infectious Diseases in Children Editorial Board. He is co-chair of the Pediatric Initiative at the Atlantic Health Care System and clinical assistant professor of pediatrics at the University of Medicine and Dentistry of New Jersey in Newark, N.J.

Disclosure: Lander is co-owner of both the National Discount Vaccine Alliance, and Resources in Physician Management Services. He is also a speaker for Merck, Novartis, Pfizer and Sanofi-Pasteur.

Influenza strikes in the United States every year, and perhaps that explains the indifference some physicians feel about immunizing their patients against the flu. It is easy to forget the devastating impact influenza can have on some patients. Luckily, the devastation can be mitigated by immunizing your patients.

Influenza has struck in the area where I practice. Both of the pediatric ICUs here have hospitalized very sick patients due to influenza. Our infectious disease consultants have urged us to continue vaccinating through March. Our work in helping our patients is far from over.

Richard Lander, MD 

Richard Lander

Before the influenza season began, physicians had been told to get ready for a bad season. With this in mind, my practice started vaccinating during the summer as soon as our influenza vaccines arrived. We gave it to the kids as they came in for their well appointments, we reached out to our high-risk patients (asthmatics, immunocompromised patients and cardiac patients), and we organized influenza parties, which assembled large numbers of patients to receive influenza vaccines at the same times. 

Some practices designated Saturdays or Sundays for immunizations, whereas others delineated specific times during the day or night for doctors, nurses and certified medical assistants dedicated specifically to give influenza vaccines intramuscular or nasally. These visits did not allow for discussions about the child’s 5-year history of encopresis or behavioral problems. We all hope to be effective in reaching large numbers of patients.

It is undeniable that vaccinating against influenza is good for patients. As luck would have it, vaccinating against influenza is good for the financial health of your practice as well. For example, let’s calculate monies generated for administering influenza vaccine for a doctor with a panel of 2,000 patients. We’ll be conservative and consider that only 1,000 patients will get their influenza vaccine in your office. Some of the 1,000 not receiving the vaccine in your office might be infants younger than 6 months of age and not eligible for the vaccine, and some patients will go to retail-based clinics or refuse the vaccine.

I know you are all financially savvy and you have purchased influenza vaccines at the lowest possible price. This would be from a group purchasing organization or directly from the manufacturer. The fee you receive has been set by your contract with each managed care organization and you are seeing a 10% to 25% profit. If your practice purchased the vaccine at approximately $10, the profit on these 1,000 patients will range from $1,000 to $2,500.

Additionally, you are receiving a vaccine administration fee, which should range from $14 to $30. This amounts to $14,000 to $30,000 for the 1,000 patients. Furthermore, in my practice, we do not vaccinate if a patient has not received a well visit in the last 12 months. If 100 patients who call for a flu shot ending up scheduling a well visit, you should be generating an additional $10,000. Bottom line: $25,000 to $42,500, which is not bad!

Influenza can be devastating. Offering influenza vaccines to your patients is good for their health. It is good for the whole community. Giving influenza vaccine is also good for the financial health of your practice.

Richard Lander, MD, is a pediatrician in private practice in northern New Jersey and is a member of the Infectious Diseases in Children Editorial Board. He is co-chair of the Pediatric Initiative at the Atlantic Health Care System and clinical assistant professor of pediatrics at the University of Medicine and Dentistry of New Jersey in Newark, N.J.

Disclosure: Lander is co-owner of both the National Discount Vaccine Alliance, and Resources in Physician Management Services. He is also a speaker for Merck, Novartis, Pfizer and Sanofi-Pasteur.