Medicaid Adult Vaccine Provider Reimbursement in 2024

This technical report assesses Medicaid adult vaccine provider reimbursement across all 50 states, Puerto Rico, and Washington, DC for the year 2024. The objective of the research, commissioned by Pfizer, is to characterize the post-Inflation Reduction Act (IRA) landscape concerning vaccine reimbursement rates. The report outlines findings that indicate significant variability in reimbursement amounts for vaccines administered in physician offices and pharmacies. It details how reimbursement rates for certain vaccines are often aligned with Medicare rates, while others remain lower. The analysis also highlights the increase in pharmacy access to vaccines compared to previous years. Despite the improvements mandated by the IRA, the report concludes that reimbursement for vaccine administration remains generally lower than Medicare levels. The findings suggest that adequate reimbursement is crucial for enhancing vaccine access and uptake among Medicaid beneficiaries, thereby addressing existing health disparities.