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September 2006

Reduce Flu and Pneumonia Hospitalizations with Proper Immunizations

August was National Immunization Awareness Month. Typically this makes us think about getting our children ready to go off to school, but it should should remind us to prepare our Medicare patients for the upcoming flu season.

As we all know, the flu is a respiratory illness caused by a virus that accounts for over 200,000 hospitalizations on average each year. With the national attention and need to reduce hospitalizations, assuring our vulnerable Medicare patients receive the proper immunizations needed to keep them healthy and out of the hospital is one of the ways in which we can do just that.

Approximately 50,000 patients die each year from flu and pneumonia, which could be reduced or eliminated by providing the appropriate vaccinations. Now that Medicare pays for both the influenza and pneumocoocal vaccinations, we can help in lowering that number. 

For all persons 65 years of age and older, the Advisory Committee on Immunization Practices (ACIP) and other authorities recommend lifetime vaccination against pneumococcal disease and annual flu vaccinations. Medicare will cover a booster pneumococcal vaccine for high-risk individuals if more than five years has passed since they last received the vaccination.

As of January 2005, all new Medicare enrollees are covered for a physical examination, which includes the immunizations for pneumonia and influenza. Also as of January 2005, physicians can be paid for injections and immunizations administered to Medicare beneficiaries. Since October 2002, home health agencies participating in Medicare and Medicaid programs can administer pneumonia and flu shots according to a standing orders protocol without the need for a physician’s examination or direct order. Quality Improvement Organizations (QIO’s) in each state are working to increase immunization rates in all health care settings.

Despite the fact that Medicare pays for the flu vaccination and pneumococcal immunizations, the Medicare beneficiaries being immunized still remains inadequate. The Centers for Medicare and Medicaid (CMS) works with the Center for Disease Control (CDC) and other organizations, such as the National Coalition on Adult Immunization, to promote vaccinating Medicare beneficiaries. 

Medicare has developed many educational products to increase awareness of any preventative services covered by the Medicare benefit. For more information about guidelines and current recommendations, please visit www.cdc.gov/nip/publications/acip-list.htm. For products to share with your Medicare patients, visit www.medicare.gov. 

Cyndi Rohret RN, BSN, CHPN, CRNI
Clinical Consultant Hospice, Briggs Corporation

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