Provider Payments And The Receipt Of Human Papillomavirus Vaccine Among Privately Insured Adolescents.

Financial concerns such as high vaccine purchase costs and inadequate insurance reimbursement are cited as a key barrier to human papillomavirus (HPV) vaccination of adolescents who are covered by private health insurance. Statistical evidence on the relationship between payments to providers for HPV vaccination and HPV vaccine uptake is limited. This study used data for 2008-14 from the MarketScan Commercial Claims and Encounters database and included adolescents ages 11-17 who had been continuously enrolled in the same noncapitated private insurance plan. Our estimates showed that a $1 increase in median provider payments in a state was associated with a 0.48-percentage-point increase in the probability of initiating the HPV vaccine series and a 0.25-percentage-point increase in the probability of receiving two or more doses. These numbers translated to an average increase of 49,435 adolescents initiating the series and 25,314 adolescents receiving two or more doses. The association between provider payments and HPV vaccine uptake was stronger among adolescents ages 11-12 than among older adolescents, and among adolescents who lived in a Metropolitan Statistical Area than those who did not.