INTRODUCTION

Although childhood immunization is a primary disease prevention strategy, children, especially low-income children, often do not receive their vaccinations on time. Up to 40% of two-year-olds do not receive their immunizations at age-appropriate intervals. During the last two decades, sporadic outbreaks of measles in the U.S. affected thousands of children and the number of cases of other preventable childhood diseases rose, while immunization levels in some urban areas have even declined.

The expansion of Medicaid benefits in the 1990s, and the increasing enrollment of Medicaid recipients in managed care sought to improve access to care for low-income children. Managed care programs, in general, have emphasized their ability to provide enhanced preventive services. In particular, primary care case management has been held up as correctly incentivized to improve preventive care. Yet, Medicaid managed care has a mixed record in achieving immunization rates at recommended levels and intervals. canadian discount drugs

This paper describes the timeliness of immunization for children in a Medicaid managed care primary care case management program. Important patient and provider predictors of appropriate immunization status were identified using claims data, health department records, and medical records.