Do doctors get paid to vaccinate?


Lately, people opposed to vaccines have been very upset about a recent finding that Blue Cross Blue Shield of Michigan has a Performance Recognition program for provider incentives, including paying $400 to providers for every fully vaccinated two year old in their practice.  This screen shot comes from page 16 of the document:




As you can see, the target is 63% of patients, so people opposed to vaccines think this means that if a provider can vaccinate at least 63% of two year olds in his or her practice, they will receive $400 per patient. As many pediatricians have between a few hundred to 1000 patients, people opposed to vaccines postulate that providers could be earning as much as $80,000 extra a year for vaccinating.

There are many problems with this claim.  First of all, most people opposed to vaccines  (POTVs) are not recognizing or posting that this program is only for BCBS of Michigan providers and only if they join the incentive program, called the Physician Group Incentive Program.  Secondly, POTVs are not clarifying this only works for patients insured by BCBS, with providers enrolled in the program. Thirdly, they are also not clarifying that the program is comprehensive and involves many different healthcare outcomes, not just vaccines. There are incentives for helping patients achieve healthy weight, healthy diabetes control, hypertension control, and more. Finally, POTVs are not sharing that these programs SAVE the insurance company money.



Blue Cross Blue Shield of Michigan is a non-profit company.  Saving $155 million a year is considerable and enables them to make healthcare more affordable for all enrollees.  They have done a seemingly tremendous job creating partnership programs with providers that save money and keep people healthy. Pediatricians earn a good living, but compared to most specialties, they earn considerably less. The average pediatrician earns $175,400 a year while cardiologists earn $525,00 a year and orthopedic surgeons earn almost that much. Clearly, pediatricians could earn far more money with other medical specialties. Furthermore, BCBS of Michigan doesn’t come anywhere near paying out the $80,000 per provider POTVs estimate because this benefit only applies to a few children.

Think about this:  How many fully vaccinated, two year old children are there in a pediatrician practice?  Pediatricians see patients from age newborn to 21. Even if they are getting $400 per fully vaccinated two year old, pediatricians usually have a case load of 1000 patients each so that would be about 45 two year olds per practice. They are not going to all be fully vaccinated. The threshold is 63% and not all providers will meet it. Assuming they do meet it, 63% is 28 two year olds so that could mean $11,000 a year, but only if they  meet the threshold. After taxes, that would be an extra $7000 a year, perhaps? And, remember, the insurance company IS SAVING MONEY by offering this and other incentives. In fact, if you browse the brochure, they pay out more for vaccines than anything else. That tells me that vaccination saves them MORE money than the other health indicators.

So what if insurers pay out providers a benefit when they vaccinate? This is about saving money, in the long run. Insurance companies save money when children are healthy. They lose money when children are chronically ill or hospitalized. This incentive is PROOF that vaccines work and save insurance companies money.

Always think for yourself.









43 thoughts on “Do doctors get paid to vaccinate?

  1. In fact, insurance company adjustments to do the right thing for patients are so paltry, it barely mitigates the chronic and systemic underpayment of primary care. This is the reason I have stopped accepting any insurance, so I can take my time, do the right things, keep up with patient needs, listen when necessary, educate when required and just not go crazy doing dumb-ass paperwork. Oh ya, and make a decent living at it.

    Liked by 1 person

  2. When cold-hearted insurance companies support a policy, it’s pretty good indication the policy cuts their costs. Chronic disease increases costs. As you point out, this incentive is more support of vaccine safety. Insurance companies certainly care about profits, and having health costs cut those. Vaccines, this shows, mean less health costs.

    Liked by 1 person

  3. It is also why tax payer funded healthcare systems fund vaccination. It saves money in the long run.

    In socialised medicine systems the government is essentially the general insurer of all the people. It has a massive financial incentive to reduce costs. They fund vaccine action because it is cheaper than treating disease.

    The exact opposite of what anti vaxxers claim.

    Liked by 1 person

    • Antivaxxers are NOT what you claim. This issue is the preservatives (THIMERISOL) in the vaccine! Do YOU know what Thimerisol is? I BET YOU DO NOT!! It is MERCURY!!! What does Mercury (A HEAVY METAL) do in a human body! Get and get back to me.


      • Please tell us which vaccine on the present American pediatric schedule is only available with thimerosal. Do not mention influenza vaccine, because three of the seven available do not have thimerosal.

        Also, if you claim the actual issue is thimerosal, then why is there such a hue and cry over the MMR vaccine. It has never contained a preservative since the first version was approved in 1971.

        Now if you are so terribly concerned about something that has not been issue for fifteen years, you need to provide the PubMed indexed articles by reputable qualified researchers written in the last five years that it is still relevant. Do not link to anything written by the Geiers, nor by anyone on this list of speakers:


      • Please don’t be stupid. If a molecule contains an atom, it doesn’t mean the molecule is the atom. Thimerosal is no more mercury than water is oxygen or salt is chlorine.
        Both are deadly when inhaled and thimerosal is proven harmless.


  4. Pingback: The Truth about vaccines 4: influenza, HIB, and pneumococcal vaccines and herd immunity | vaccinesworkblog

  5. My pediatrician friends, on the whole, vaccinate at a net loss. They express extreme frustration over parents who suspect vaccination and THEM for pushing it. Some of them refuse to take unvaccinated patients, which infuriates those parents. I’m not a pediatrician – something I am more grateful for every day – but like them, I spent many years in university (13) and supervised clinical training (6) in order to HELP people. If my plan was to get rich, I would have gone into business. I certainly wouldn’t have spent a couple of very expensive decades getting trained!

    Pediatricians want to care for children. They take the greatest pleasure in seeing children thrive and it grieves them when children suffer. The things I hear from anti-vaxxers leave me thunderstruck. Sent those parents to the third world so they can see some unvaccinated populations.

    Liked by 1 person

    • Here in Washington state, the state buys the vaccines for children that are not covered by the federal vaccines for all children program. So much for getting rich of vaccines here!

      I agree with you about 3rd world countries.


  6. Chris, the MMR vaccine was first introduced in 1988, you lose all credibility saying it hasn’t been in the vaccine since 1971. And yes MMR vaccine still contain Thimerosol. The CDC and FDA were trying to fedefend themselves regarding Thimerisol in congress only a couple of years ago.

    Kathy, parents are being forced to fully vaccinate their kids for preschool/day care, school and some Paediatricians are refusing to see them otherwise so 63% is nothing and the numbers you quote are very strange i.e. “23 – 2 year olds in a year if they see 100 patients” ?
    Firstly they see more than 1000 per year, secondly why only 2 year olds ? It’s not just 2 year old who meet the criterior, where did you get this nonsense from ? Did you just parrot the CDC who are part of government (Pharmaceautical industry are the biggest lobbiests/donors behind the oil companies) with their (CDC) advisory board full of employees of Pharmaceautical compsnies which sell vaccines such as Merck) while the CDC own 56 patents and distribute vsccines for $$$ and Director (Julie Gerberding) sold 2.3 million dollars in Merck shares and is now the vise president for Merck.

    Reised, Insurance companies are paid by vaccine companies, simple. Ask some people you know in the insurance industry, oh you don’t know any but are an expert on insurance and vsccines ?

    Of course most medical Doctors simply go by what Pharmaceautical companies who sell vaccines say as most of their training after diagnosis was based on using pharmaceautical drugs relieve symptoms rather than to find and treat the underlying cause snd the only vaccine training they got was the schedule and bias for them. Add to this pharmaceautical reps developing a relationship with them, also including financial insentives and you have very loyalcusomers who don’t question it unless something major wakes them up and they start researching the ingredients and who is conducting the research etc.


    • The CDC holds patents on technologies it develops. They lease those out to any scientists That money then goes back into funding more CDC research. Vaccines are products of many technologies, so the CDC does not hold any patents on vaccines.

      In my state, Washington, all vaccines for children are purchased by the state or the federal government. Doctors don’t bill. They get them free. That throws your whole argument to the wind.

      Pharmaceutical companies are also banned from the entire hospital where I live, which is the only hospital in our county, and the medical centers they run, which includes all the pediatricians in our county of 250,000 people. They are further banned from the family medicine network I see.

      Oh, and guess what? The hospital and medical centers have a 99% vax rate amongst staff and my family med doctor and his partners and all their staff are 100% vaxxed. His kids, too. And theirs!

      Insurance companies love to pay for vaccines, in other states, along with other healthy lifestyle choices, because that decreases their costs overall. If you don’t think insurance companies are about saving money, then you have never met an actuary.

      Sorry, I do not buy into the paranoid conspiracy theories.


    • “Chris, the MMR vaccine was first introduced in 1988….”

      In the UK. It was introduced in the USA 1971, and was the preferred vaccine for the 1978 Measles Elimination Program:

      You lose all credibility if you think that only the UK counts. There are various forms of an MMR vaccine that differ around the world. There is one that was developed in Russia, another in Japan… and in the USA. The MMR vaccines used in the USA and UK have never used thimerosal, because it would make it useless. (it comes as a freeze dried powder that is reconstituted with sterile water, which needs to be kept cool and used within a few hours)

      Also, the American MMR vaccine has never contained the Urabe mumps vaccine strain (which was developed in Japan). It has only ever used the Jeryl Lynn mumps vaccine, which is named after the developer’s daughter. There is a book about him, you should read it and expand your knowledge beyond the UK:
      Vaccinated: One Man’s Quest to Defeat the World’s Deadliest Diseases by Paul A. Offit

      Liked by 1 person

    • You are deluded and misinformed.
      There is no thimerosal in MMR and I opposed the removal on the grounds that there was no scientific basis for the concern and that it would feed the lunacy of the anti-science brigade.
      As for the proposition that doctors “just go with” what the reps say, it is laughable. If you think all physicians are sheep that concede to whatever someone else tells them, then you have never been to a physicians’ meeting and you don’t understand the culture of independence bred amongst physicians. This is the land of “it didn’t get done unless you did it yourself.” You are clearly ignorant regarding all the things about which you profess knowledge, but that’s pretty much “the usual” for the anti-science crowd. Don’t even know how to make a proper argument that hangs together or has any logical cohesion. Also known as fiction; and bad fiction to boot.

      Liked by 1 person

      • “There is no thimerosal in MMR and I opposed the removal on the grounds that there was no scientific basis for the concern and that it would feed the lunacy of the anti-science brigade.”

        Very good points. Though we should clarify that some vaccines never ever contained thimerosal because the antimicrobial effect would have made some vaccines useless. From :
        “Measles, mumps, and rubella (MMR) vaccines do not and never did contain thimerosal. Varicella (chickenpox), inactivated polio (IPV), and pneumococcal conjugate vaccines have also never contained thimerosal.”

        One clue that someone does not know about the subject is when they say something like “the thimerosal in the MMR vaccine.” 😉


      • Vaccines are poison, research the ingredients or your opinion is not valid! Aborted babies and animals to make cultures?? Messing with DNA?? Cancer anyone!!


      • Wiki explains this accurately so I am copying from them

        “In biology, poisons are substances that cause disturbances in organisms, usually by chemical reaction or other activity on the molecular scale, when an organism absorbs a sufficient quantity.[1][2]

        The fields of medicine (particularly veterinary) and zoology often distinguish a poison from a toxin, and from a venom. Poisons are toxins produced by organisms in nature, and venoms are toxins injected by a bite or sting (this is exclusive to animals). The difference between venom and other poisons is the delivery method. Industry, agriculture, and other sectors use poisons for reasons other than their toxicity. Pesticides are one group of substances whose toxicity to various insects and other animals deemed to be pests (e.g., rats and cockroaches) is their prime purpose.”

        Nothing in vaccines is poison and nothing in vaccines is toxic at those doses.


  7. Pingback: That $3 Million Vaccine Bonus for Pediatricians – VAXOPEDIA

  8. Your numbers appear to be way off. Using the numbers from “Size and age-sex distribution of pediatric practice: a study from Pediatric Research in Office Settings:”

    The average number of kids in a practice is around 1500, not 1000, and it’s heavily skewed younger (“more than half of the children were aged 6 years or younger”).

    So let’s say 750 are 6 or younger. That put 2-year olds at 250 in the practice, not 45. 63% of 250 is 157 kids. Thus, at least $63,000 is on the line, not $11,000.

    63% is easy to meet in a compliant population. Probably most doctors in this program are making their numbers.

    “Kathy” signs off with “think for yourself.” I would add, “and use real-world data to make estimates.”


      • “If there are 1500 kids in a pediatrics practice and those kids are between birth and 21, how on earth could here be 250 2 year olds?”

        The distribution is not even, according to the citation, so I just divided by three. May not be correct, as your subsequent comment shows but we are getting closer to the real numbers.

        Regardless of whether it is a bonus or not, it’s a lot of money on the line that disappears if the threshold of vaccination is not met. Thus, is it solely because of the concern for the children that the pediatrician is advocating for vaccination? Obviously not because the incentive system would not be in place if the plan administrator didn’t find that incentives were needed.


      • “The money used to make the payout or incentive reward comes from “a percentage of the applicable fee schedule on most professional paid claims.” So it is, in effect, money that the pediatrician has earned and should have already been paid. And if they don’t meet HEDIS performance measurements, they don’t get that money.”

        from the vaxopedia link

        Yes, insurance companies want to incentivize healthy living choices that save them money in the long term. Can you blame them for wanting to cut costs?


      • “a percentage of the applicable fee schedule on most professional paid claims.”

        Sure, 1%, 10%? Without saying how much we don’t know what the bonus amount is. Could be mostly bonus amount from what you have written; we just don’t know.

        And, again, regardless of the bonus amount, the *entire* amount is on the line if 63% of the kids are not vaccinated, assuming all the other measures are met.

        Parents should know that their pediatrician, if they are in this program (but probably others, too), has a great monetary incentive to have their child vaccinated and take that into account if the pediatrician recommends this medical procedure. At this point, the pediatrician has become a sales person reaching for their incentive payout.

        This is exactly what the program administrator wants, btw, because they have designed the program that way to have the pediatrician work to get the bonus money. The program administrator has purposely added additional financial incentive to encourage vaccination. I am simply stating the obvious.


      • Andre, it is not a bonus. Not sure why cannot understand how this works. Did you even bother to read the BCBS of MI pamphlet?

        Parents should know that their insurance company pays 100% of well check visits and their doctor bills the insurance company so he or she can get paid for services rendered. Patients should be happy their insurance company is promoting healthy living choices because saving money means lower insurance rates.

        Do you know about HEDIS?


      • “The money used to make the payout or incentive reward comes from “a percentage of the applicable fee schedule on most professional paid claims.”

        Given your own words that include “incentive reward,” the customary way of interpreting that is as a bonus (or “incentive”) offered when a measure is met. Further, it says that the incentive reward comes from “a percentage of the applicable fee.” It is just “a percentage” precisely because the remainder is a bonus to incentivise the doctor to meet the measures.

        Now you are saying that there is no bonus, which makes no sense given what you have written above.

        Further, regardless of whether there is a bonus, the entire amount is on the line. This alone is a *very great* incentive to make sure that the measures are met. Who wants to lose $33k in income and possibly more if one has a bigger practice? (five doctors x $33k = $150k)


      • Well, if they don’t sign up for the program and/or they don’t meet the many healthy living goals, they won’t get the incentivized part of the reimbursements. It is up to the doctor. They can refuse to help their patients prevent disease, stop smoking, take their diabetes meds, or whatever and just make less money. The insurer will need that extra money to pay the extra healthcare costs associated with less healthy patients. It’s a win-win program.

        Of course, in my state, it’s moot point since all vaccines for children are paid for by feds or the state. No programs here like the BCBS of MI 2016 program.

        It is still true that doctors are not paid to vaccinate. They are just reimbursed/paid less if they don’t vax their patients.


      • “Well, if they don’t sign up for the program and/or they don’t meet the many healthy living goals, they won’t get the incentivized part of the reimbursements.”

        Very good. This is an incentive program that a doctor can voluntarily sign up for that will compensate them at a higher rate per individual child compared to if they do not participate in the program. In everyday language, it is a bonus program similar to what one finds all across the business world. We’re making progress.

        “It is still true that doctors are not paid to vaccinate.”

        Such a shame. I actually thought we were getting somewhere. Yes, doctors are paid to vaccinate:
        • they make a small amount of profit on the vaccines themselves
        • they make an administrative fee for the visit that typically is larger than the profit of the vaccine
        • they may participate in one of many bonus programs that encourage higher vaccination via their insurance plan or by various levels of the state.

        Dr. Paul Thomas runs through the numbers for his practice:
        “Just doing the selective vaccines that I do on the vaccine friendly plan in the last eight years, I’ve lost over $1 million just in vaccine profits. I’m still getting the well-child visit income; the insurance company reimburses me for doing the well visit, but there was an administration fee for each vaccine and a tiny little profit, a dollar or two, that’s hopefully worked into each vaccine. It’s a huge loss of income.

        The reality is, for most pediatricians, the profit from the markup on the vaccine itself is almost nothing. I’d say, probably, you could pay $100 for a vaccine and you’re going to get reimbursed $102 – a couple of bucks. You do get an admin fee, which is just for the labor of administering it, and that’s some profit – probably in the range of $12-$15 per shot. If you’re giving six vaccines to a two-year-old and there’s an admin fee for each one, there’s $100 right there for each kid each time. It adds up. A well-baby visit is usually a half hour appointment because you’re covering more than just giving the shots. You’re doing a full exam and you’re talking about development, what to expect and a lot of those things.”

        Of course they are paid to vaccinate and, depending on how large the practice is, the profits can be substantial (primarily because of the administration fee per shot).

        Here is my first cut of an estimate for a child who follows the complete CDC schedule (2017) by age 18:
        • 34 single and multi-valent shots
        • 18 flu shots

        Profit from the vaccines, using Dr. Thomas’ numbers:
        • $2 x 52 = $104 (I think the profit on the flu vaccine might be higher but I’d have to look into that)
        • 52 administration fees x $13 (avg) = $676
        • well-baby visit (90% are used just to give vaccines, don’t need a doctor visit every two months): $?? per visit; leave out for now

        So the best I can do with the data I have is $780/child. A practice of 1500 kids is worth $1,170,000 at a given point in time just for vaccines. Over a 40 year career it’s probably four times that and I haven’t even added the “vaccine injection visits,” er, the “well-baby” visit compensation from the insurance companies, which might increase that by 20% or more.

        Of course they get paid to vaccinate. That looks like pretty good money to me.


      • Andre, being paid to vaccinate implies doctors are paid only to vaccinate, for not other reason. This is a health benefit program where the doctor’s fees are less if they don’t meet HEDIS goals. Yes, that means they get paid less if they don’t meet healthy goals. That does not, in my book, translate to doctors are paid to post. Plus, in WA state, there are NO programs like this at all. All vaccines are free to doctors.

        I don’t believe one word Paul Thomas says. He never verifies his claims. Evidence or move along. But, if he doesn’t buy the vaccines, then he doesn’t get to bill for them. Insurers rarely reimburse the entire cost of vaccines anyway. Peds usually eat the difference because they want to keep their patients safe. And if he does not do well visits on the recommended schedule, then he is also not losing any money.

        What a ridiculous claim. Vaccines and the associated bookkeeping likely cost the office far more than $780 per child. He is billing insurance for his costs plus and making a good profit.

        You are an idiot. Go away.


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