Washington State: How an Immunization Registry Is Funded Can Determine Its Success

In an effort to convert the CHILD Profile (Children's Health, Immunization, Linkages, and Development) from a public, grant-supported project to a fee-for-service model, a cost-based pricing structure for users of the system was established, based on the number of children in their client load under age 6.

The goal was to have the registry "primarily supported" by fee-for-service as of January 2000. But it became clear that providers were resisting the fee-for-service arrangement, and that not only had fees contributed just 1 percent of the revenue budget, but they also had resulted in providers holding negative views of the registry.

As of June 2000, only 25 percent of provider sites were submitting data to the registry, despite aggressive marketing efforts and enhancements to the registry to make it more useful, such as reminder-recall and vaccine inventory functions.

Registries should clearly define the value proposition. What will the registry do for its users?

A strategic planning process, conducted by an outside consulting firm and facilitated by the Foundation for Health Care Quality, concluded in March 2000.

Its recommendation that subscription fees for health care provider groups be eliminated was acted upon. Health plans, however, continued to pay fees for immunization data used in Health Plan Employer Data and Information Set (HEDIS) reporting.