HPV Vaccine Articles and New Resources

Academic Pediatric Articles
The March issue of Academic Pediatrics offers a CDC-sponsored supplement, "Raising Human Papillomavirus Vaccination Rates." The supplement reviews 10 years of HPV vaccination experience and offers 7 commentaries and 11 articles, with topics ranging from parent and provider perspectives to information about the integration of HPV vaccine into health systems.

While there have been advances and successes in the HPV vaccination program in the U.S., the uptake of HPV vaccine remains lower than expected. The supplement articles explore the challenges faced with this vaccine and approaches that are being used to address them.

Topics include:
- Influence of provider communication techniques on parental attitudes toward HPV vaccine
- Evaluations on breadth of HPV counseling materials
- Quality improvement methods for improving HPV vaccination rates in clinical practice
- Discussions on the continued challenges of improving HPV vaccination coverage
- Comparative analysis of recommended HPV vaccine interventions
- Opportunities for creating vaccination coverage initiatives that extend beyond the health care setting

The information and perspectives offered in the supplement can provide the foundation for discussion as we strive to improve HPV vaccination coverage.

HPV Cancer Data for Massachusetts
A recent study was published in Cancers Causes Control entitled "Trends of two HPV-associated cancers in Massachusetts: cervical and oropharyngeal cancer." The article looks at the trends for both incidence and mortality of two HPV-related cancers, cervical and oropharyngeal, in Massachusetts and shows the increasing incidence of oropharyngeal cancer in males.

National HPV Roundtable Action Guides
The National HPV Roundtable just released Clinician and Health System Action Guides for various clinician types as well as health care systems. These guides offer practical advice on how to increase HPV immunization rates to decrease HPV-related cancers and tailors the message to specific audiences.

Here are the 6 types of Action Guides:

Clinician Guides:
· Action Guide for Physicians, Physician Assistants, and Nurse Practitioners
· Action Guide for Nurses and Medical Assistants
· Action Guide for Dental Health Care Providers
· Action Guide for Office Administration Staff

Health Systems Guides:
· Action Guide for Small Private Practices
· Action Guide for Large Health Systems

Finland Article
A new article in the International Journal of Cancer entitled "Vaccination protects against invasive HPV-associated cancers" is the first to show population based evidence of HPV vaccine protecting against invasive cancer. The article uses two Finnish vaccination trial cohorts and unvaccinated control cohorts.There were no cases of HPV-related cancer found in vaccinated women, compared to 10 cases among the unvaccinated. The rates of non-HPV related cancers did not significantly differ between the groups.

Effect of Communication Intervention
An article in JAMA Pediatrics "Effect of a Health Care Professional Communication Training Intervention on Adolescent Human Papillomavirus Vaccination: A Cluster Randomized Clinical Trial" demonstrates the effectiveness of communication interventions in increasing HPV vaccination rates in Colorado. Among 43,132 patients at 16 practices participating in this cluster randomized clinical trial, a 5-component intervention significantly increased HPV vaccine series initiation, stopped decline of completion, and was effective for both boys and girls. Two specific intervention components, communication training and customized HPV fact sheets, were the most used and useful based on health care professionals' report. This study highlights the importance of communication intervention training in increasing HPV immunization rates for both boys and girls.

HPV Coalition
Would you like to get more involved in activities to increase HPV vaccination? Please join us at the next meeting of the Massachusetts Coalition for HPV/HPV-Related Cancer Awareness, which will on Tuesday, April 10th at 4:00 P.M. after the Massachusetts Adult Immunization Conference at the Best Western Royal Plaza, Marlborough. You do not need to attend the Adult Immunization Conference to attend the HPV Coalition meeting.

AAFP offers 5-page MACRA executive summary

The AAFP created a five-page executive summary to help explain the most relevant parts of the Medicare Access and CHIP Reauthorization Act to family physicians.

Some of the highlights of the summary include these need-to-know informational nuggets:

  • CMS' inclusion of a "pick-your-pace" policy gives physicians choices as to how fast they proceed and includes an optional 90-day reporting period in 2017.
  • If a practice participates in the Merit-based Incentive Payment System (MIPS) for any period of time in 2017, no penalty will be assessed in 2019.
  • All physicians who participate in Medicare Part B will receive a positive 0.5 percent payment update for services provided in 2017.
  • Physicians should plan to participate in 2017 -- even if only by reporting on one measure or improvement activity; failure to do so will result in a 4 percent negative adjustment in 2019 Medicare Part B payments.

Other resources available:
Review AAFP's side-by-side comparison.
Understand your pathway. PDF is available to members only (You'll need your member id and password)
Not familiar with all the acronyms yet? See AAFP's list of MACRAnyms.

MACRA Recap and What's to Come 


The US Senate passed MACRA of 2015 HR 2 by a vote of 92-8 in April 2015. The legislation was previously passed by the House 392-37 in March. President Obama signed the law into action which followed a White House Ceremony celebrating the SGR repeal later that month.

The MACRA repealed the flawed Medicare sustainable growth rate (SGR) formula that calculates pavement rates to physicians. The legislation established an alternative set of annual payment updates to replace the SGR:

  • Repeals the SGR
  • Establishes a defined payment system that transitions away from fee-for-service
  • Preserves fee-for-service, but under strict quality performance standards
  • Provides financial assistance to small/solo practices to facilitate transformation
  • Streamlines current quality and performance programs into a single program
  • Sets a date certain for electronic medical record (EMR) interoperability
  • Establishes expectations regarding the use of quality and performance data in medical liability cases

Other significant Provisions include extending funding for:

  • CHIP
  • Teaching Health Center Graduate Medical Education (GME)
  • Community Health Centers
  • National Health Services Corps

What does this mean for you, the member?

  • The annual update for July 1, 2015 through 2019 is set at 0.5%
  • For years 2020-2025 the annual update is set at 0.0%
  • For years 2026 forward the annual update is set at 0.75% for qualifying alternative payment models (APM) participants and 0.25% for all other physicians


Ready to transform your practice?

Prepare for MACRA's Quality Payment Program (QPP)—for free—with the Transforming Clinical Practice initiative (TCPi). Through collaborative, peer-based learning networks, the Transforming Clinical Practice initiative (TCPi) helps practices just like yours prepare for value-based payment.

TPCi's quality improvement advisors will help you identify areas of opportunity for practice transformation and provide technical assistance based on your practice's needs.

Additionally, you will be eligible for:

ABFM Family Medicine Certification-Performance Improvement Activity for participating with a Practice Transformation Network (PTN)
PRIME Family Medicine Registry
MIPS Improvement Activity credit for PTN participation
TCPi is offering practice transformation support, and the AAFP is here to connect you with a PTN that meets your needs. Email us to learn more.


AAFP Resources