As I look around my part of the country, I can’t help but notice that leaves are starting to change colors, football fans of all flavors are gearing up for competition and pharmacies are stocked up with flu vaccine — ready to begin administration of the annual flu shots.
Last year’s influenza epidemic proved to be the nation’s worst in the past 10 years, with the Centers for Disease Control and Prevention (CDC) reporting 26 times more flu cases during the last three months of 2012 than during the same period in 2011. It is estimated that less than half of all Americans receive a flu shot in any given year, but history suggests that following a flu epidemic there tends to be increased and early immunizations the following season. These points all suggest a potential for a very busy immunization season this fall.
Further, according to the American Pharmacists Association, the number of pharmacists nationwide trained to deliver vaccines has quadrupled since 2007. And we also know that the retail pharmacy continues to increase as a destination for customers to receive a flu shot.
When asked “Where did you get your flu shot (choose one response that best describes the location you got your flu shot),” respondents reported:
|Your regular physician's office||41.9|
|Walk in clinic||12.6|
|Some other place||7.2|
There is still a lot of room for improvement in not only U.S. citizens receiving the flu shot but also those receiving one in the pharmacy setting. One way to increase this traffic is to inform the communities that not only are flu shots given at the pharmacy but other immunizations such as Zostovax, Tdap and Pneumonia as well. At Emdeon, we continue to see significant growth year-over-year with not only flu claims billed to medical plans, which have grown by 100% over both of the past two flu seasons, but also other types of immunizations, which have grown by a tremendous 475% over the previous year’s claims.
As more patients become aware that pharmacies can provide a plethora of immunizations, their comfort level with receiving an immunization there is expected to rise as well.¹
On top of that, with medical billing solutions leading the way for pharmacies to bill medical benefit claims, patients no longer have to worry about paying cash or billing their insurance for vaccinations at the pharmacy in most cases. In 2012 for example, Emdeon saw an increase of 78% for new plans billed over 2011 and a 338% increase over the plans billed in 2010. Further, Emdeon has seen a large increase in retail pharmacies that are eager to utilize this billing solution with a 33% increase in retail customers in 2012 and 115% over 2011 utilizing medical benefit claim filing.² As more and more patients choose the convenience of their pharmacy to receive all types of immunizations, companies like Emdeon will be right there to make sure the pharmacies benefit from operational ease and accurate, prompt payments.
So, with all that being said, and considering that the majority of my work life this time of year focuses on immunizations, you would think I would be the first in line for my flu shot every year, right? Well, actually, wrong. I’m scared to death of needles. Have been for as long as I can remember BUT earlier this year I experienced a life-changing event that will guarantee I get my annual flu immunization — needle or otherwise. My family welcomed twins into the world and I obviously do not want them contracting the flu from me. Besides, I just happen to have inside knowledge that my pharmacy will be able to bill my health plan seamlessly for the vaccination. Then I can enjoy decking out my twins in full Steelers outfits and wave my Terrible Towel without a second thought of a runny nose.
About the Author
Mike Carmody is the director of DME/MedRx pharmacy services at Emdeon. He is responsible for pharmacy solution product development and workflow efficiencies. Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers, providers and patients in the U.S. healthcare system.
¹, ² Emdeon proprietary data based on claims originated at the pharmacy and billed health plan under medical benefit.