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Health Care Final 10-15-09 -   4.1.a - Two Year Old Immunization Rates for Medicaid

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Health Care Final 10-15-09
Healthy State
Economic Recovery
Action Plan

4.1.a - Two Year Old Immunization Rates for Medicaid Managed Care

Are Washington immunization rates continuing to improve for Medicaid managed care clients?

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Data Notes

Data Source:

Health Employer Data and Information Set (HEDIS); Plan member-level datasets from six Healthy Options (HO) plans: Asuris Northwest Health, Community Health Plan, Columbia United Providers, Group Health Cooperative, Kaiser Permanente Northwest, Molina Healthcare of Washington, and Regence BlueShield
Measure Definition: Medicaid Managed Care (Healthy Options) Immunization Rates
Target Rationale: National Committee for Quality Assurance (NCQA) Average [short-term]; NCQA 75th percentile [long-term]

Link to Agency Strategic Plan:


The HRSA 2009-13 strategic plan stresses the value of preventive care, including immunizations and well-child check-ups. Increasing two-year old immunization rates among Medicaid children in managed care is identified as one of HRSA's goals for increasing the use of evidence-based care to bring about better health outcomes for our clients. Immunization rates are also identified as a performance measure reflective of a medical home.



Childhood immunizations show significant health benefits, including reductions in child morbidity and mortality, cost-savings to the health care system, and benefits to society. 

Notes: (optional)




COMBO 2: Diphtheria, Tetanus, Whooping Cough, Polio, Measles, Mumps, Rubella, Influenza, Hepatitis B and Chickenpox

Period: Service years 2004 through 2008 (reported in subsequent calendar years, e.g., 2004 data reported in 2005)

NCQA Combo 2 data for service year 2009 will be available October/November 2009.

Also Available
Action Plan: Yes
Extended Analysis: Yes

 Summary Analysis

The DSHS Healthy Options' (HO) 2008 immunization rate of 71.4% for Combo 2 (diptheria, tetanus, whooping cough, polio, measles, mumps, rubella, influenza, hepatitis B and chickenpox) is less than 1% below the National Committee for Quality Assurance (NCQA) average rate of 72.1% for 2007 [NOTE: 2008 NCQA data will not be available until October/November 2009]. 

The HO Combo 2 rate continues to improve: all but one of the six DSHS HO plans reported an increase in rates from 2007 to 2008.  

  • Combo 2 Immunization Rates By HO Health Plan
  • One HO plan had a statistically significant decrease in HO Combo 2 immunization rates (from 61.8% in 2007 to 55.96% in 2008). This plan had significant administrative changes this past year which impacted its ability to report performance measure data. A corrective action plan is being implemented for this HO plan.
  • If this one plan's performance had remained at its previous statuts, the DSHS HO 2008 Combo 2 rate would have been 72.5% for 2008.
  • Within the Combo 2 cluster, 2 individual antigens (for influenza and chickenpox) showed statistically significant increases in administration while 1 individual antigen (hepatitis B) showed a statistically signficant decrease. Even so, the immunization rate for the hepatitis B vaccine is 88%.
  • Rates for Selected Individual Antigens in Combo 2

The HO Combo 2 immunization rate (71%) for 2008 is on par with the statewide rate (73.5%) reported by DOH for 2008.