When we talk about preventive care, vaccination sits at the top of our list. But, despite our best efforts, immunization rates continue to fall short ¹. Why? Often, it’s a mix of factors ranging from a lack of patient education to widespread misconceptions about vaccines that keep people from getting the vaccinations they need. If we truly wish to improve health outcomes and boost health plan quality measures for programs like HEDIS and Medicare Star Ratings, we need to rethink our approach.

Over the past twenty years, I’ve had the opportunity to work closely with pharmacies and health plans, and I’ve witnessed how immunization strategies have evolved. What once was the sole domain of primary care offices has been transformed with the active participation of pharmacies. They are not only providing convenient accessibility for vaccination services but also delivering essential education to patients on the benefits of vaccines and vaccination administration. 

Let’s explore how integrating Community Pharmacy in your immunization strategy can drive better outcomes, close care gaps, and reduce costs.

Why Are Pharmacies the Missing Link?

Pharmacies can play a key role in any immunization strategy due to their ability to reach members where they already are. Here’s what makes them invaluable: 

• Pharmacies are everywhere: Around 58% of Americans² walk into their local pharmacies regularly for comprehensive care. Their unparalleled proximity, walk-in availability, and extended hours provide a patient reach that few traditional care settings can match. Plus, pharmacies help eliminate some common barriers to immunization, such as long travel times and scheduling hassles. In rural and underserved areas where healthcare access is limited, pharmacies can be a vital resource for ensuring timely vaccinations and keeping community health on track.

• Patients trust pharmacies: Pharmacies can be less intimidating spaces for individuals who feel hesitant to visit their doctors for immunizations. The majority of consumers polled in the PQS 2022 Trend Report in Pharmacy Quality³ responded that they feel comfortable or very comfortable (69%) receiving shots or injections from a pharmacist in 2022, the same proportion who had indicated comfort in 2019. By acting as trusted spaces for care, pharmacies can ensure better patient engagement and increased uptake of vaccinations.

• Pharmacies offer an economic advantage: Partnering with pharmacies can be more cost-effective for health plans. Research and real-world experience, such as the COVID-19 Pandemic pharmacy response, indicate⁴ that since pharmacies currently have the infrastructure needed to administer vaccines, they can cut down on overall expenses. This not only leads to savings for health plans but also boosts vaccination rates.

• Pharmacies act as convenient data touchpoints: Pharmacies are well-equipped to track and share real-time immunization data, which is crucial for improving vaccine tracking and follow-ups with patients. This capability fits perfectly with the CMS 2027 requirements, which focus on moving quality reporting from manual charts to a claims-based model. By generating accurate and timely claims, pharmacies will become vital partners for health plans looking to maintain compliance.

How Pharmacy-Based Immunization Programs Boost Patient Engagement

Pharmacy-based immunizations have the potential to transform how health plans connect with members about preventive care. Take vaccine series completion, for example. We all know how challenging it can be to get members back for their second or third doses. However, pharmacies can help close this gap through personalized reminders. A simple reminder that says “Your next shingles vaccine is due”, especially when received from a trusted pharmacist, can be highly effective in ensuring that patients show up for their shots.

We shouldn’t overlook the role of a pharmacy technician either. These frontline team members often nurture lasting relationships with patients. When trained, these technicians can support the immunization process,  starting from screening to administering, thus extending the pharmacy’s vaccination capacity while maintaining a personal connection with members of the community. Health plans that partner with pharmacies, leveraging their technician workforce, can see much broader vaccination coverage without sacrificing the human touch.

Thanks to their frequent contact with patients, pharmacists are in a unique position to enhance patient engagement and keep health conversations ongoing. They can raise awareness around vaccinations through in-store materials like posters or outreach activities like health fairs and mobile clinics. Pharmacies can play an important role in providing information about preventive care to underserved populations. These efforts align well with health plans that want to close care gaps and improve HEDIS measures across diverse populations.

Boosting Immunization Outcomes: How Health Plans Can Leverage Pharmacies

Pharmacy partnerships are not just limited to delivering vaccines, they can act as a powerful driving force for enhancing health plan performance in several key areas. Here’s how: 

• Improving Health Equity: Health plans can leverage pharmacists to address disparities in access to vaccines, improving health equity. During the COVID-19 era, approximately 305.5 million doses⁵ of the COVID-19 vaccine were delivered by pharmacies.  They also partnered with local organizations and schools to reach underserved populations, boosting vaccine rates among racial and ethnic minorities. These collaborations offer a chance to close care gaps and improve plan performance on equity-focused quality measures. 

• Integrating pharmacies into immunization campaigns: Pharmacies can act as key partners in public health campaigns that are aimed at increasing vaccine uptake. For example, they can conduct outreach events and provide immunization services. These efforts promote awareness and encourage increased participation in vaccination programs. 

• Real-time reporting and data-sharing for better decision-making:  Pharmacies can be a valuable data source for vaccine reporting and analytics in real-time. By integrating their systems with health plan databases and registries, pharmacies can provide instant updates on vaccine administration. This can help track coverage levels, identify gaps, and prioritize outreach. Through this timely exchange of information, health plans can make evidence-based decisions and ensure compliance with metrics like HEDIS and Star Ratings. The ability to track vaccine trends at a granular level strengthens public health response and improves overall program efficiency.

The PQS Solution

PQS by Innovaccer enables health plans to fully unlock the capabilities of their pharmacy networks. Our EQUIPP® platform provides pharmacies with the data and tools they need to create impactful immunization programs. Pharmacies receive real-time patient data every week, along with alerts in their workflow about immunizations that could be administered, enabling them to proactively deliver key vaccines to their patients. EQUIPP also enables transparent tracking at both the NPI and member levels. By providing end-to-end support, PQS by Innovaccer ensures effective engagement with the pharmacy network.

Final Thoughts

Reflecting on my journey working with both pharmacies and health plans, one thing has become clear: we need to build stronger collaborations with pharmacies. By arming them with the right technology and data, we will not only drive up vaccination rates but also build a more resilient and efficient healthcare system. I believe by continuing to nurture these partnerships, we can truly redefine the future of preventive care. 

Learn how your health plan can benefit from a pharmacy channel. Contact us.

References

1. Seither, R., MPH, Yusuf, O. B., PhD, Dramann, D., MPH, Calhoun, K., MS, Mugerwa-Kasujja, A., MD, & U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, MMWR. (2024). Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2023–24 School Year. In Morbidity and Mortality Weekly Report (Vol. 73, Issue 41). 
2. Wolters Kluwer’s Pharmacy Next survey shows 58% of Americans are likely to first seek non-emergency healthcare at pharmacies. https://www.wolterskluwer.com/en/news/survey-shows-americans-seek-non-emergency-healthcare-at-pharmacies
3. Sega, T., Thorne, A., Boyd, B., Chung, N., & Endres, E. (2022). Industry Trend Report in Pharmacy Quality.
4. Romero-Mancilla, M. S., Mora-Vargas, J., & Ruiz, A. (2023). Pharmacy-based immunization: A systematic review. Frontiers in Public Health, 11, 1152556. https://doi.org/10.3389/fpubh.2023.1152556
5. Centers for Disease Control and Prevention. (2023, July 25). Vaccines & immunizations: The federal retail pharmacy program for COVID-19 vaccination. https://www.cdc.gov/vaccines/covid-19/retail-pharmacy-program/index.html