The Affordable Care Act and Childhood Immunization Delivery in Rural Communities

Year: 2014
Funding: Pre and Post-doctoral Scholar in Public Health Delivery Award (PPS-PHD)
Status: Completed

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This study examines how the delivery of childhood immunization services has changed in small, rural California communities as the Affordable Care Act (ACA) and related health system reforms are implemented. After considering how healthcare collaborations are implemented for medically underserved populations, including local health departments (LHDs), primary care providers, medical facilities, and other community based providers, the project estimates the LHD costs of various options for delivering immunization services and their possible effects on the health status of vulnerable populations in their communities.

LHDs are challenged to identify the safety net services that they will need to maintain to serve the residual uninsured populations. This research describes the LHD costs of various options for delivering immunization services, to assist policymakers in small LHD jurisdictions considering the costs and potential health status impact of the service options. Implementation of the ACA in California, expansion of Medi-Cal eligibility, and redirection of indigent medical care funding from counties to the state are causing LHDs to redefine their roles and responsibilities for improving population health. This research on immunization service costs provides information for developing policy decision support tools for other safety net services in small counties.

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Van Do-Reynoso
University of California, Merced