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HealthInsight Selected by CMS to Improve Immunization Rates and Reduce Disparities

The HealthInsight Quality Innovation Network-Quality Improvement Organization (QIN-QIO) has been selected by the Centers for Medicare & Medicaid Services (CMS) to begin work on reducing disparities and improving immunization rates and assessment of immunization status for Medicare beneficiaries.

As of April 17, 2015, the HealthInsight QIN-QIO began working with physicians and practitioners, home health agencies, and critical access hospitals to improve influenza, pneumonia and shingles (zoster) vaccinations among Medicare beneficiaries across Nevada, New Mexico, Oregon and Utah. The HealthInsight QIN-QIO will also work with individual state immunization registries to support this work.

CMS expects a desired national outcome of 1 million previously unimmunized Medicare beneficiaries receiving pneumonia vaccinations by 2019. The HealthInsight QIN-QIO aims to achieve a target of 50,000 of these previously unimmunized beneficiaries regionally, accounting for 5 percent of the national goal.

Three of HealthInsight’s four states, Nevada, New Mexico and Utah, currently have below average pneumonia vaccination rates for adults aged 65 and over. The fourth state, Oregon, has the highest pneumonia vaccination rate in the country at 75.6 percent, above the established target for this task. Oregon will be used as a “best practice” state for pneumonia vaccinations and HealthInsight will use the lessons learned to increase pneumonia vaccination rates in Nevada, New Mexico and Utah.

Each of the four states performs well below the national average in influenza vaccination rates. During the 2013−2014 influenza season, Nevada had the lowest rate in the nation at 36.4 percent. The most successful state was New Mexico, with a rate of 46.6 percent. Oregon had the second highest rate at 42.2 percent, and Utah was third at 41.5 percent.

Improving zoster vaccination rates will be a new activity for the HealthInsight QIN-QIO states, as this preventive benefit is covered differently by Medicare insurance. Pneumonia and influenza vaccinations are normally covered by Medicare Part B, while zoster vaccinations are typically covered by Part D, or prescription drug plans.

“The states in the HealthInsight QIN-QIO have several years of experience in improving pneumonia and influenza vaccination rates,” said Jerry Reeves, MD, senior vice president of medical affairs. “We look forward to collaborating with physician offices and home health agencies to adopt and promote proven best practice approaches to inform our work.”

“A critical aspect of this task will be strengthening collaborations between the state immunization registries and the health care practices to facilitate the exchange of vaccine-related information,” said Deepthi Rajeev, PhD, medical informaticist for HealthInsight. “We are excited to pave the way to increasing immunization rates and improving adoption of immunization guidelines and standards in our four states. We will leverage our broad experience in integrating health information technology and quality improvement to support the various needs of the health care communities.”

With the award of this contract, HealthInsight expects to have a positive impact on immunization rates for between 24 and 33 percent of the Medicare beneficiaries across the region, with a particular focus on vulnerable populations with low vaccination rates.