Removing Out-of-Pocket Costs for Adult Vaccines Throughout the U.S.
Situation
The benefits of vaccines are well-known and documented, including disease prevention and economic benefits. Historically, many states did not provide comprehensive coverage of adult vaccines, hindering vaccination uptake and resulting in higher rates of vaccine-preventable morbidity and mortality. Beginning October 1, 2023, state Medicaid programs are required to provide all Advisory Committee on Immunization Practices (ACIP)-recommended vaccines at no cost to adults enrolled in the program.1 States that implement these requirements, promote the removal of out-of-pocket (OOP) cost-sharing for adult vaccines and encourage vaccination among Medicaid-eligible adults could realize millions of dollars in annual cost savings. See findings from Arkansas, Florida, Georgia, South Carolina, and Texas below:
Our Role
The Adult Vaccine Access Coalition (AVAC) partnered with FTI Consulting to assess the impact of provisions under the Inflation Reduction Act (IRA) that will address long-standing gaps and out-of-pocket cost barriers to adult vaccine coverage in the U.S. Specifically, FTI Consulting’s scope of work focuses on the importance and benefits of state-level implementation. FTI Consulting’s Center for Healthcare Economics and Policy modeled potential cost savings in five states by estimating the number of disease incidences prevented and treatment costs avoided due to increased vaccine uptake of four ACIP-recommended vaccines as a result of the IRA’s vaccine access provisions. Using these findings, FTI Consulting’s Healthcare & Life Sciences, Public Affairs team developed five fact sheets that highlight key findings, data points, and messaging from our research in each of the five states to provide stakeholders, partners, and advocates with the tools, considerations, and information necessary to effectively call for the swift implementation of vaccine access provisions at the state-level. These materials are publicly available on the AVAC website and will be disseminated to public health and immunization officials, payers, providers, advocates, partners, and other stakeholder audiences.
We’d like to share our experience with you. Let’s work together.
[1] Centers for Medicare & Medicaid Services State Health Official Letter, June 27, 2023. https://www.medicaid.gov/sites/default/files/2023-06/sho23003.pdf
