Executive Summary

The federal and state partnership in supporting immunization programs that benefit the general population evolved over the last half of the 20th century from a simple cost-sharing arrangement for vaccine purchase for disadvantaged children to a more complicated mix of programs, health care coverage benefits, and public-private partnerships. The mix of financial arrangements that support immunization efforts was the subject of a study by the Institute of Medicine, resulting in the publication of the report Calling the Shots (Institute of Medicine, 2000).

The IOM report highlighted key concerns about the growing instability of the public health infrastructure that supports immunization programs throughout the United States. The report recommended that state and federal health agencies establish a new framework to guide their collaborative efforts, one that consists of six fundamental elements:

  • Controlling and preventing infectious disease

  • Assuring vaccine purchase

  • Assuring service delivery

  • Sustaining and improving coverage levels

  • Conducting surveillance of immunization coverage and vaccine safety

  • Establishing immunization finance policies and practices

In June 2001, a group of 50 health officials, public health experts, health care providers, health plan representatives, and community leaders



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Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop Executive Summary The federal and state partnership in supporting immunization programs that benefit the general population evolved over the last half of the 20th century from a simple cost-sharing arrangement for vaccine purchase for disadvantaged children to a more complicated mix of programs, health care coverage benefits, and public-private partnerships. The mix of financial arrangements that support immunization efforts was the subject of a study by the Institute of Medicine, resulting in the publication of the report Calling the Shots (Institute of Medicine, 2000). The IOM report highlighted key concerns about the growing instability of the public health infrastructure that supports immunization programs throughout the United States. The report recommended that state and federal health agencies establish a new framework to guide their collaborative efforts, one that consists of six fundamental elements: Controlling and preventing infectious disease Assuring vaccine purchase Assuring service delivery Sustaining and improving coverage levels Conducting surveillance of immunization coverage and vaccine safety Establishing immunization finance policies and practices In June 2001, a group of 50 health officials, public health experts, health care providers, health plan representatives, and community leaders

OCR for page 1
Setting the Course: A Strategic Vision for Immunization Finance - Part 1 Summary of the Chicago Workshop met at the University of Illinois in Chicago to explore the implications of the IOM findings and recommendations for the states of Illinois and Michigan. The one-day workshop was the first in a series of four meetings organized by IOM with support from the Centers for Disease Control and Prevention to foster informed discussions about future financing strategies for the public health infrastructure that supports immunization efforts. This report of the Chicago workshop summarizes the findings of the IOM study and reviews the challenges that remain in establishing a reliable financial base for the U.S. immunization system. The report high-lights strategies presented by workshop speakers and discussants for achieving immunization goals, including increases in state and federal public health budgets, the addition of quality improvement measures in health plans, performance-based contracting, public policy actions, and the creation of public-private partnerships. The Chicago workshop participants emphasized the need for collaborative efforts that would encourage private health plans and providers to assume responsibility for achieving high coverage rates among children and adults within the communities that they serve. Collaborative strategies are needed to engage the health care, business, and government sectors in identifying opportunities to achieve public health immunization goals. New approaches that use information resources efficiently and reduce reliance upon public resources will be required to meet persistent and routine needs.