Working with managed care organizations to build population-based immunization registries

Managed care organizations (MCOs) and their provider networks are emerging as a primary organizational model for the provision of health insurance and the delivery of health care services. MCOs have unique needs for health care data and large data sets that they collect on their current patient population, which make them ideal partners for building large-scale, population-based immunization registries. As patients move between plans, the lack of continuous patient data makes it difficult for MCOs to document provider performance on a number of key indicators, including immunization. MCOs are being required at the state and national levels to demonstrate performance. This makes these organizations highly motivated to participate in efforts to build a common data base that can be shared among providers as well as MCOs. This also presents the challenge and need for public health-based immunization registries. Public health organizations implementing population-based immunization registries are certain to be faced with questions of how MCOs will be able to contribute to and benefit from such registries. For the Milwaukee and Philadelphia All Kids Count projects, the experiences of each project's interactions with MCOs are described and compared here. Conclusions are drawn concerning the ways in which future immunization registry projects will need to adapt to take advantage of the strong alliances and partnerships which MCOs have frequently offered to public health-managed immunization registries.