Adult immunization rates have remained low despite increased awareness and availability of adult vaccines.   To increase adult influenza and pneumococcal vaccination rates, the Qsource works with providers, beneficiaries and communities to:

• implement evidence-based practices and systems changes to improve routine assessment of patients’ vaccination status;
• increase documentation of Medicare beneficiary immunization status in immunization information systems (IIS) where available for adult patients;
• facilitate a call to action in communities to engage in the improvement of senior adults vaccination.

Helping patients stay up-to-date on recommended vaccines is an important part of what providers do to keep their patients healthy and avoid serious illness, disability, and deaths. Focusing on adult immunizations has the potential to make a substantial impact on care outcomes and overall patient health. Providers can put their efforts on immunizations to work for them by using immunization-related activities to earn points toward the Quality Payment Program targets.

Providers are eligible to participate in MIPS if they bill Medicare more than $90,000 a year and provide care for more than 200 Medicare patients a year. Providers in the MIPS track will receive a performance-based payment adjustment to their Medicare payment by earning points in four different categories – quality, improvement activities, promoting interoperability, and cost. For three of the categories, immunization activities can be reported for points towards MIPS.

Immunization quality measures that are eligible for MIPS points include:

• Influenza vaccine, all ages – percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
• Pediatric vaccine series – percentage of children 2 years of age who had completed the recommended immunizations by their second birthday
• Adolescent vaccine series – percentage of adolescents 13 years of age who had the recommended immunizations by their 13th birthday
• Pneumococcal vaccine, adults – percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.

Improvement Activities: Participation in Maintenance of Certification (MOC) part 4 activities for improving professional practice, including participation in a local, regional or national outcomes registry or quality assessment programs, can count towards MIPS improvement activities requirements.

Advancing Care Information:

• Clinicians participating in MIPS can earn up to 10% of their promoting interoperability bonus score through optional immunization registry (immunization information systems = IIS) reporting.
• The Promoting Interoperability (PI) score is the combined total of the following three scores: Required base score (50%), Performance score (90%), and Bonus score (15%). In the PI score (weighted at 25% of the total score), MIPS eligible clinicians may earn a maximum score of up to 155%, but any score above 100% will be capped at 100%.
• MIPS eligible clinicians must attest “yes” to being in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the IIS to add a 10% bonus to their overall performance score. Active engagement means that the clinician is in the process of moving towards sending “production data” to a public health agency, or is sending production data to a public health agency. Note that the immunization measure for registry reporting is yes/no, as opposed to numerator/denominator, so a “yes”=10%, while a “no”=0% for this measure.

More information on the MACRA Quality Payment Program, MIPS, and Advanced APMs can be found at www.qpp.cms.gov .