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Front Page » Ethics » Bioethics » Financial Incentive for Doctors to Fully Vaccinate Patients?
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Financial Incentive for Doctors to Fully Vaccinate Patients?

I get a lot of emails from people who wonder if doctors have any sort of financial incentive to get their patients vaccinated. Do we get any sort of bonus from the insurance companies that pay us? I’ve always thought that the answer to this question was no. I recently found out otherwise.

Now, if you count the fact that part of the income for a doctor’s office comes from providing vaccines themselves, and the checkups that go along with the vaccines, you could argue that that’s a financial incentive. Yes, doctors’ offices do make a little money on vaccines. But I don’t really count that as an actual incentive to try to talk any patients into getting vaccines or as a reason to kick a patient out of a practice if they don’t vaccinate. I don’t think any doctor would kick someone out just because the doctor isn’t going to be able to make as much money on an individual patient who doesn’t get vaccines.

But I recently talked with two physicians in different states that told me the HMO plans that they contract with do chart reviews and patient surveys at the end of each year. If their office scores high enough on these reviews, the HMO plan gives them a several thousand dollar bonus. This bonus varies depending on the number of patients the doctor sees. One of the requirements for a patient’s chart to pass the test is that they are fully vaccinated.

Now, I can somewhat understand the logic behind this. The insurance wants to make sure all their clients are fully vaccinated so they don’t catch any particularly severe disease that might result in an expensive hospitalization or disability that would cost the insurance company a lot of money. Oh, and they probably also care about their clients overall health and wellbeing too. So, why not give their doctors a bonus for meeting this goal?

Here’s why. This policy gives any doctor who contracts with such HMO plans an incentive to NOT want any unvaccinating families in their practice. Maybe a few such families wouldn’t make them fail the chart reviews, but if they have too many, there goes their year-end bonus. One colleague here in southern California told me that he happily gives up this bonus because he wants to serve these families. Good for him! But I bet that many doctor across the U.S. refuse care to these families solely because they don’t want to lose this bonus. They make so little from the HMO plan as it is that losing this bonus could make them actually lose money caring for these families. In fact, this bonus isn’t actually a bonus at all. It is actually money that should be paid to the practice anyway month by month, but it is held back until the year-end surveys are done. I don’t know of any PPO plans that do this, fortunately.

I’ve always wondered by so many doctors are so adamantly hardcore about demanding all their patients fully vaccinate, and why they kick patients out of their office who refuse. I’d always just assumed it was because the doctors felt that the vaccine protection was so important that they don’t want any children to be at risk, so they draw a line in the sand for the good of the child (in their minds). BUT some doctors, especially those large groups who rely heavily on large HMO contracts, may actually be doing this because of money. Do they have the right to do so? Of course. But is it right? I don’t know. The American Academy of Pediatrics Committee on Bioethics makes it very clear that the official AAP policy is that doctors NOT kick patients out of their office over this issue. But when money talks, some people don’t listen.

So, knowing this information doesn’t really help parents one way or another. But I thought you’d find it interesting to know why you might be having a hard time finding a vaccine-friendly doctor.

Note: This article was reprinted with the author’s permission. It was originally published on Dr. Sears’ website at www.askdrsears.com.

7 Responses to Financial Incentive for Doctors to Fully Vaccinate Patients?

  1. Kirstin Beatty Reply

    September 17, 2015 at 2:21 pm

    The solution to this is to pass a law forbidding this practice. Sounds like that might be difficult, but it still is worth trying. Physicians also need to be protected from forcing drugs on patients–a general law would apply to vaccinations as well.

    • Bouncedancer Reply

      May 9, 2016 at 3:15 pm

      It might get worse before it gets better. That’s the problem with “the standard of care” — a cookie-cutter way of treating patients that is one size fits all, and the doctor who goes outside this narrow line risks his/her license. They tried that with the law, but the judges rebelled. However, they weren’t fighting the behemoth that is Big Pharma/our government, which has every intent on pushing drugs on everybody according to official rules.

  2. Etie Reply

    November 30, 2015 at 10:19 am

    Until the official study comparing total health and brain function profiles of vaxd vs unvaxd ppl for every age group is done – that’s using very large samples – then the truth of how they make money has to be that vaccinated children have many many more “diagnoses” than unvaxd children or adults. As 1 of many friends who are already grandmothers can attest – unvaxd children rarely have any kind of “diagnosis” at all, thank G-d!

  3. Walter Reply

    May 9, 2016 at 2:09 pm

    Taking your child to the pediatrician is becoming more like taking them to Jiffy Lube. You can never just go for the service you need. They always try to up-sell you into other services—wether you want them or not.

    The difference is that in the pediatrician’s office, your child could be injured or killed by accepting this service you didn’t want in the first place.

  4. Shan Reply

    May 9, 2016 at 8:00 pm

    Imagine what would happen if they could foresee the cost associated with a vaccine injury…

  5. Silvia Reply

    May 10, 2016 at 9:17 pm

    This article gave me an idea. If the insurance company knew that vaccines cause injury and that not taking the vaccine would lower the costs with health and doctors as people would not get sick or injured, maybe the insurance company could start fighting the vaccine industry. How amazing would it be if the Insurance Company discovered that people who don’t vaccinate are healthier and don’t go to the doctor so often as the ones who vaccinate? Let’s pitch to the insurance company and let’s make them know what is going on.

  6. Kurt Reply

    May 13, 2016 at 6:47 pm

    My solution is: I just don’t visit doctors at all. Period and end of story. If pharma corruption weren’t part of the equation, I might. But it is, and so I don’t. That means LESS money for the doctor. Once there are enough like me doing the same, they won’t get our money OR the annual bonus lol

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