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Vaccine Quality Measures

How do adult vaccination rates affect your CMS quality scores?

The Adult Immunization Status (AIS) measure is gaining traction as a core HEDIS^® quality measure, and it has been revised to include additional vaccines to report beyond pneumococcal and influenza vaccines.^1-4*

The AIS measure assesses the proportion of adults who are up to date on influenza, herpes zoster (shingles), pneumococcal, Td or Tdap, and hepatitis B vaccinations.⁴

As of 2025, the AIS measure is:

Part of the CMS Universal Foundation set, replacing the stand-alone influenza and pneumococcal vaccine measures^2,5

Available for selection in Merit-Based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP)^5,6†‡

Included in the 2026 Medicare Star Ratings display page based on the 2024 measurement year^3§

Beyond financial incentives, opting in to report the AIS measure can help your health system:

Meet CMS requirements for systems' vaccination rates^5,6
Better understand your vaccination rates⁷
Identify gaps and address disparities in underserved populations^7,8
Streamline reporting across value-based care programs⁹

For more information on the benefits of the AIS measure and reporting requirements for MIPS, review the resources below.

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^*The Healthcare Effectiveness Data and Information Set (HEDIS®) is a registered trademark of the National Committee for Quality Assurance (NCQA). HEDIS measures were established by the NCQA to evaluate health plan quality of care and are commonly used in value-based care programs, including CMS programs.^3,4,10

^†MIPS is a Medicare quality program used by CMS to reimburse providers and health systems for Part B–covered professional services. Participation is generally mandatory for providers or groups that bill Medicare Part B, though there are exemptions in certain circumstances. Quality represents 30% of the final score for payment adjustments and is based on 6 of over 200 possible measures chosen, including the AIS measure.^11,12

^‡MVPs are a MIPS reporting option that is proposed to be mandatory by approximately 2028. Each MVP includes a subset of measures and improvement activities (clinical activities that support the improvement of clinical practice, care delivery, and outcomes) that are related to a select specialty or medical condition. As of 2025, the AIS measure has been finalized in 5 MVPs, allowing providers to select and report this measure from a small subset of quality measures.^13,14

^§Public reporting of AIS data to the Star Ratings display page enables plan-level comparisons and benchmarking. Given the inclusion of the AIS measure on the Star Ratings display page beginning in 2026, the measure may be considered for inclusion in Star Ratings for future years. Public comment is the opportunity for the public to provide input on proposed rules, regulations, or legislation during a set time period.^3,15

CMS=Centers for Medicare & Medicaid Services; Td=tetanus and diphtheria; Tdap=tetanus, diphtheria, and acellular pertussis.

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References

National Committee for Quality Assurance. HEDIS® 2019 Volume 2: Technical Update. October 1, 2018. Accessed March 16, 2026. https://www.ncqa.org/wp-content/uploads/2018/10/HEDIS-2019-Volume-2-Technical-Update.pdf
The Universal Foundation. Centers for Medicare & Medicaid Services. Updated June 26, 2025. Accessed March 16, 2026. https://www.cms.gov/medicare/quality/ cms-national-quality-strategy/universal-foundation
Announcement of calendar year (CY) 2025 Medicare Advantage (MA) capitation rates and Part C and Part D payment policies. Centers for Medicare & Medicaid Services. April 1, 2024. Accessed March 16, 2026. https://www.cms.gov/files/document/2025-announcement.pdf
HEDIS^® MY 2025 measures and descriptions. National Committee for Quality Assurance. Accessed March 16, 2026. https://ncqa.org/wp-content/uploads/HEDIS-MY-2025-Measure-Description.pdf
Calendar year (CY) 2024 Medicare physician fee schedule (PFS) final rule fact sheet and policy comparison table. Centers for Medicare & Medicaid Services. Accessed March 16, 2026. https://www.cms.gov/files/document/2024qpppoliciesfinalrulefactsheet.pdf
2024 MIPS clinical quality measure specifications and supporting documents: Quality Payment Program. Quality ID #493 (CBE 3620): Adult Immunization Status. Quality Payment Program. December 2023. Accessed March 16, 2026. https://qpp.cms.gov/docs/QPP_quality_measure_specifications/CQM-Measures/2024_Measure_493_MIPSCQM.pdf
Esselman K, Ciemins EL, Donckels E, Barbera C, D’Andrea G, McBride T. Using quality measures to drive improvements in immunization rates: findings from a real-world evaluation from 3 US health care organizations. Popul Health Manag. 2022;25(3):423-429. doi:10.1089/pop.2021.0197
Rodrigues CMC, Plotkin SA. Impact of vaccines; health, economic, and societal perspectives. Front Microbiol. 2020;11:1526. doi:10.3389/fmicb.2020.01526
CQMC announces updates to eight core measure sets. News release. AHIP. August 17, 2023. Accessed March 16, 2026. https://www.ahip.org/news/press-releases/cqmc-announces-updates-to-eight-core-measure-sets
Number of HEDIS® covered lives tops 200 million. National Committee for Quality Assurance. January 12, 2022. Accessed March 16, 2026. https://www.ncqa.org/ blog/number-of-hedis-covered-lives-tops-200-million/
Merit-based Incentive Payment System (MIPS) : traditional MIPS scoring guide for the 2022 performance year. Quality Payment Program. Accessed March 16, 2026. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1970/2022%20Traditional%20MIPS%20Scoring%20Guide.pdf
How is eligibility determined? Quality Payment Program. Accessed March 16, 2026. https://qpp.cms.gov/eligibility-participation/eligibility/determination
Learn about the MVP reporting option. Quality Payment Program. Accessed March 16, 2026. https://qpp.cms.gov/mips/mvps/learn-about-mvp-reporting-option
Calendar year (CY) 2025 proposed and modified Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs). Quality Payment Program. Accessed March 16, 2026. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2877/2025-Proposed-and-Modified-MVPs-Guide.pdf
Advance notice of methodological changes for calendar year (C Y) 2024 for Medicare Advantage (MA) capitation rates and Part C and Part D payment policies. Centers for Medicare & Medicaid Services. February 1, 2023. Accessed March 16, 2026. https://www.cms.gov/files/document/2024-advance-notice-pdf.pdf

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Vaccine Quality Measures

How do adult vaccination rates affect your CMS quality scores?

The Adult Immunization Status (AIS) measure is gaining traction as a core HEDIS^® quality measure, and it has been revised to include additional vaccines to report beyond pneumococcal and influenza vaccines.^1-4*

The AIS measure assesses the proportion of adults who are up to date on influenza, herpes zoster (shingles), pneumococcal, Td or Tdap, and hepatitis B vaccinations.⁴

As of 2025, the AIS measure is:

Part of the CMS Universal Foundation set, replacing the stand-alone influenza and pneumococcal vaccine measures^2,5

Available for selection in Merit-Based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP)^5,6†‡

Included in the 2026 Medicare Star Ratings display page based on the 2024 measurement year^3§

Beyond financial incentives, opting in to report the AIS measure can help your health system:

For more information on the benefits of the AIS measure and reporting requirements for MIPS, review the resources below.

Tools and Resources

We Want to Hear From You!

Request Additional Information

References

Vaccine Quality Measures

How do adult vaccination rates affect your CMS quality scores?

The Adult Immunization Status (AIS) measure is gaining traction as a core HEDIS® quality measure, and it has been revised to include additional vaccines to report beyond pneumococcal and influenza vaccines.1-4*

The AIS measure assesses the proportion of adults who are up to date on influenza, herpes zoster (shingles), pneumococcal, Td or Tdap, and hepatitis B vaccinations.4

As of 2025, the AIS measure is:

Part of the CMS Universal Foundation set, replacing the stand-alone influenza and pneumococcal vaccine measures2,5

Available for selection in Merit-Based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP)5,6†‡

Included in the 2026 Medicare Star Ratings display page based on the 2024 measurement year3§

Beyond financial incentives, opting in to report the AIS measure can help your health system:

For more information on the benefits of the AIS measure and reporting requirements for MIPS, review the resources below.

Tools and Resources

We Want to Hear From You!

References

The Adult Immunization Status (AIS) measure is gaining traction as a core HEDIS^® quality measure, and it has been revised to include additional vaccines to report beyond pneumococcal and influenza vaccines.^1-4*

The AIS measure assesses the proportion of adults who are up to date on influenza, herpes zoster (shingles), pneumococcal, Td or Tdap, and hepatitis B vaccinations.⁴

Part of the CMS Universal Foundation set, replacing the stand-alone influenza and pneumococcal vaccine measures^2,5

Available for selection in Merit-Based Incentive Payment System (MIPS) and MIPS Value Pathways (MVP)^5,6†‡

Included in the 2026 Medicare Star Ratings display page based on the 2024 measurement year^3§