Peer-reviewed article
"It really is HPV that's pulling us down": Findings from a health plan quality improvement learning collaborative targeting the HEDIS IMA measure.
Shaylen Foley, Ashleigh Flowers, Jennifer Isher-Witt, Katherine Crawford, Jennifer Nkonga et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A quality improvement learning collaborative convened by the American Cancer Society engaged health plans across the United States from 2022 to 2024 to increase HPV vaccination rates among adolescents. Participating health plans implemented tailored interventions with support from ACS, including data tools and best-practice sharing. The collaborative achieved statistically significant increases in HPV vaccine completion rates and overall immunization measures across three annual cohorts.
Key points
- HPV vaccination completion increased by 3.0 percentage points in both 2023 (p < .01) and 2024 (p < .001)
- Overall HEDIS IMA measure improved by 3.0 percentage points in 2023 and 2.0 percentage points in 2024
- The 2024 collaborative included 26 health plans covering 249,927 enrolled 13-year-olds across 17 states
- Qualitative successes included intervention adaptations, early initiation at age 9, data use for decision-making, and inter-organizational collaboration
- Barriers to sustained progress included project duration limitations, staff turnover, and challenges with provider buy-in
Limitations
The study does not include a comparison group of health plans not participating in the collaborative, making it unclear whether observed improvements would have occurred without the intervention. The analysis is limited to aggregated data from participating plans and does not examine individual-level factors affecting vaccination decisions.
Abstract
The human papillomavirus (HPV) vaccine could prevent 37,000 HPV-related cancers annually in the U.S. yet uptake is suboptimal. Health plans cover 95% of children, implement quality improvement (QI) interventions, and report the Healthcare Effectiveness Data and Information Set (HEDIS®) Immunizations for Adolescents (IMA) measure. The American Cancer Society (ACS) convened payors in the ACS HPV Vaccination Learning Collaborative from 2022 to 2024 in three 12-month cohorts. Participants set QI targets, implemented interventions, and joined best-practice sharing calls. ACS provided a data reporting tool, resources, and one-on-one support. Plans submitted aggregated vaccination data. We used Wilcoxon Signed Rank test to assess average rates pre- and post-intervention. Ten participants consented to 60-minute semi-structured interviews that we transcribed and analyzed thematically. In 2022, we engaged 27 plans (35 service lines) from 19 states with 264,089 enrolled 13-year-olds. In 2023, participants represented 14 plans (16 service lines) from 11 states with 127,554 enrolled 13-year-olds. The 2024 collaborative included 26 plans (39 service lines) from 17 states with 249,927 enrolled 13-year-olds. We saw significant percentage point (pp) increases in 2023 for HPV completion (+3.0pp, p < .01), meningococcal (+3.3pp, p < .05), tetanus, diphtheria, & pertussis (Tdap) (+4.8pp, p < .01), and IMA (+3.0pp, p < .01) and in 2024 for HPV completion (+3.0pp, p < .001), Tdap (+1.7pp, p < .05), and IMA (+2.0pp, p < .001). Qualitative successes included intervention adaptations, age 9 initiation, data use, and collaboration. Barriers included project duration, turnover, and provider buy-in. We found the QI learning collaborative model acceptable to health plans and supported implementation of QI interventions to increase HPV vaccination.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Health plan quality improvement learning collaborative providing participating plans with QI targets, implementation support, data reporting tools, resources, best-practice sharing calls, and one-on-one coaching to increase HPV vaccination rates
- Population
- 13-year-old children enrolled in participating health plans across multiple U.S. states (264,089 in 2022, 127,554 in 2023, 249,927 in 2024)
Key finding
HPV vaccine completion increased 3.0 percentage points in 2023 and 3.0 percentage points in 2024