Project Abstract: RFA-IP20-2001
Immunization Barriers in the United States: Targeting Medicaid Partnerships
AcademyHealth and Immunize Colorado Collaborative Project:
Eliminating Barriers to Immunization through State Interagency and Community Collaboration
BACKGROUND. Despite enhanced coverage through Medicaid and the Vaccines for Children Program, low-income children and pregnant women continue to have lower estimated vaccination rates than those above poverty level. While this disparity is influenced by many factors, interagency and multi-stakeholder collaboration with Medicaid programs can strengthen their ability to understand and address barriers to improving immunization rates among these vulnerable populations, including immunization information systems interoperability, provider scope of practice, among others. Now, with the COVID-19 pandemic, it will be especially valuable to address the potential health implications from delayed vaccination schedules and well-child visits.
PURPOSE & APPROACH. AcademyHealth (AH), in collaboration with Immunize Colorado (IC) and potential partnership with the National Academy for State Health Policy (NASHP), will build on our current funded project, Immunization Barriers in the United States: Targeting Medicaid Partnerships. This proposal aims to engage with the Medicaid Medical Directors Network (MMDN) and other Medicaid stakeholders using a multi-faceted strategy to enhance collaborative immunization efforts across pertinent state agencies and improve immunization rates for children and pregnant women with Medicaid coverage.
1. Formation of a Community of Practice. Engagement will first involve the formation of a Community of Practice (CoP) comprised of approximately 3-5 states consisting of a small group of stakeholders who share similar challenges or decisions and collaborate to address these issues through a series of virtual and face-to-face exchanges. Mirroring the original CoP team structure, the CoP will include a Medicaid Medical Director (MMD) or Medicaid agency team lead, an Immunization State Program Manager, and a State Immunization Information System (IIS) Coordinator. In addition, the new CoP team will also include a physician champion to foster additional knowledge sharing. CoP engagement will address barriers to and share promising practices for increasing immunization rates for children and pregnant women with Medicaid. Project activities will include in-person and virtual engagement opportunities such as regular conference calls, webinars, an annual CoP Immunization meeting, and technical support.
2. Engagement of the Medicaid Medical Directors Network (MMDN). Broader engagement will involve our longstanding partnership with over 40 active states participating in the MMDN to add to and disseminate CoP lessons and best practices to achieve wider outreach and impact. We will leverage various MMDN dissemination activities such as monthly newsletters, “Open Mic” conference calls, and an online web forum to communicate findings.
OUTCOMES. This project will demonstrate progress related to three short-term outcomes: (1) At least two states participating in the CoP will create additional opportunities to facilitate vaccination of children living in poverty; (2) At least two states participating in the CoP will create additional opportunities to facilitate vaccination of pregnant women living in poverty; and (3) At least two states participating in the CoP will create additional opportunities to facilitate improvements in IIS. While measuring progress on intermediate or long-term outcomes as outlined in the RFA can be difficult, we have learned through our current CoP engagement that there is a direct connection between the short-term project outcomes and those longer-term goals. Through shared learnings and applied improvements in immunization policies, practices and funding, vaccination rates will increase among lower-income children and pregnant women leading to