As the 2018-2019 flu season winds down, your physician practice should begin preparation for the 2019-2020 flu season. Immunizing your patients against the latest strains of the influenza virus is a year-round activity that can improve the health of your patients and your practice.

However, trends in the flu vaccine market are making those clinical and financial goals more challenging. Let me identify what those trends are and how you can overcome them. Next, we’ll discuss what your practice can do between now and the start of the next flu season. And we’ll review lessons learned from this flu season that your practice can apply to the next flu cycle.

Flu vaccine market trends

The flu vaccine market trend that’s having the biggest effect on your physician practice is the change in where patients get their flu shots. Over the past five years, about one-third of adults who received a flu shot got it at their doctor’s office. But we’re starting to see a drop in that percentage.

Of the adults who got a flu shot in the fall of 2018, 34.3 percent got them from their doctor, according to the Centers for Disease Control and Prevention. That’s down slightly from 34.7 percent from the same time a year earlier.1

More adults are getting their flu vaccines from pharmacies, other retail stores and where they work. For example, this past fall, 32.2 percent of adults got their flu shot at a pharmacy or another retail site. That’s up significantly from the 18.4 percent who got them at a pharmacy or store for the 2012-2013 flu season.2

This trend can be explained by these factors:

  • Convenience. Today’s patients want convenience. They want to get their flu shot when it’s most convenient for them, and the best place for that is their local pharmacy.
  • Access. Patients want access to flu shots right away. Retail pharmacies typically start to vaccinate as soon as doses hit the market.

Impact on your physician practice

When your patients choose a pharmacy, store or workplace for their flu shot and not your practice, it could affect you in a number of different ways.

Your primary concern is clinical—as it should be. If one of your patients gets their flu shot at another location, you have no way of knowing. That leaves a gap in their medical record. The CDC recommends that all healthy adults get a seasonal flu vaccine to immunize them against the flu virus. It’s important from a personal health standpoint and a public health standpoint. If you’re responsible for the health of that patient, that’s a gap in care that you don’t know about.

Research also shows that patients who get flu shots enjoy indirect health benefits, particularly patients with chronic illnesses. If your patient suffers from heart disease or diabetes, for example, you don’t know whether someone else vaccinated them or whether that immunization is helping protect them in other ways.

The other concern is financial. When a patient doesn’t come to your practice for a flu shot, you can’t charge for an office visit, and you can’t charge for the dose of flu vaccine that you administered. That can have a bigger impact if your practice is sitting on boxes of unused vaccines that you purchased.

A less obvious financial effect could come from value-based care contracts with your health plans. Those contracts may link your payment rates to quality and cost outcome measures. One measure may be your flu vaccination rates of patients under those contracts. And if your patients don’t get flu shots and end up in the hospital, those contracts could ding you for high utilization costs.

Top ways to reverse the trend

Preparing Your Physician Practice for the Next Flu SeasonClearly, being the flu shot destination of choice for your patients is in your physician practice’s best clinical and financial interest. So how do you stop that flu shot business from drifting away to pharmacies, stores and workplaces? The answer is to address the causes of patients getting their flu vaccines elsewhere.

Here are six things your practice can do:

1. Pre-book your vaccine orders. Typically in March, the FDA gives drug manufacturers the OK to make vaccines based on the influenza virus strains projected by the World Health Organization for the flu season that starts six months later, in October. Based on your past vaccine orders and your anticipated need for the 2019-2020 flu season, you can pre-book your order for delivery in August. That way, you’ll have your vaccine supply on hand at the same time as, if not sooner than, local pharmacies and employers.

2. Set flu reminders in your EHR. If your patient doesn’t tell you and you don’t ask, you have little way of knowing whether that patient needs a flu vaccine. You can set up your EHR system to remind you to ask each time a patient comes in for an office visit or sets up an appointment for a visit. Not only will those alerts remind you to ask, they will reinforce to your patients that flu shots are available at your practice.

3. Pre-schedule shots for patients. With your pre-booked supply of flu vaccines confirmed in July and arriving in August, you can begin pre-scheduling vaccine appointments for your patients in June and July. You can contact them by phone, text or talk to them during their visit. What you’re doing is actively setting up appointments for them starting in August to come in for their shots. Then, when they see that flu sign outside their local pharmacy, they’ll walk by it because they’ll remember that you’ve already scheduled them to come in to your office.

4. Set up walk-in vaccine days. Patients like to be able to walk in to their local pharmacies without an appointment to get a flu shot. Why not do the same thing at your practice? You can designate days and blocks of time that any of your patients can walk in and get their flu shots without an appointment. It’s convenient for patients, and it’s efficient for your practice.

5. Just-in-time inventory system. You want to avoid running out of flu shots when your patients come in for a vaccination. You should pre-book your order by the end of April based on your projected need and confirm and place your final order by the end of July. When patients start arriving in August for their shots, you need to manage your inventory in real time to avoid being caught short and to make sure you have enough on hand to care for your patients. Most distributors will let you return a percentage of your unused vaccines at no charge to reduce your financial risk if you order too much.

6. Maintain an annual flu calendar. Your practice should maintain an annual flu calendar that details what your practice should be doing each month and each quarter throughout the year as part of your flu vaccine program for your patients. As you can see, a successful flu vaccine program takes planning, and planning begins as soon as your practice sees its last flu patient of the season.

Key lessons from this flu season

No two flu seasons are alike, yet there are some lessons from the 2018-2019 flu season that just ended that could help your physician practice prepare for the upcoming season.

First, the CDC said flu vaccine rates were up this season compared with the last season for both children age six months to 17 years and for adults age 18 and older.3 That shows that more people will get their shots if you make them more convenient, accessible and affordable.

Second, the efficacy of this season’s vaccine was higher than the vaccine used last season. That may be because vaccine sites administered more cell-based vaccines than egg-based vaccines. Your practice may want to order cell-based vaccines this upcoming season, but those vaccines cost more. That cost-benefit analysis should be part of your flu vaccine plan for 2019-2020.

Finally, vaccines that treat three strains of the influenza virus will no longer be available in the U.S. Only vaccines that treat all four strains will be available for your practice to administer to patients.

With the right planning and execution, your practice can become your patients’ destination of choice for their annual flu vaccines. They’ll be healthier, and so will your practice.

Related: Learn more about McKesson’s flu vaccine and resources for physician practices

Sources:

1 Early-Season Flu Vaccination Coverage—United States, November 2018, CDC
2National Early Season Flu Vaccination Coverage, United States, 2012-2013 Flu Season, CDC.
3Early-Season Flu Vaccination Coverage—United States, November 2018, CDC

Omar Bateh

About the author

Omar Bateh is director of vaccines for McKesson Medical-Surgical. He is responsible for managing the core vaccine and flu vaccine portfolio with Rx Category Management. He has 19 years of experience in the pharmaceutical industry, 10 years of retail and nine years in distribution.

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