• MIPS Manual 2017—Know the Basics: Advancing Care Information (ACI) Overview

    Written By: Rebecca Hancock, Flora Lum, MD, Chris McDonagh, Cherie McNett, Molly Peltzman, Jessica Peterson, MD, MPH, and Sue Vicchrilli, COT, OCS

    This content was excerpted from EyeNet’s MIPS Manual 2017.


    Table 4: Advancing Care Information (ACI) Overview

    First Steps

    Decide whether to participate in MIPS as an individual or as part of a group. There are pros and cons to each approach. (See “The Pros and Cons of Group Reporting.”)

    Pick how you’ll report ACI measures. Choose to attest through the CMS web portal, your EHR vendor, or the IRIS Registry web portal.

    Your EHR system must be a certified EHR technology (CEHRT). There are 2 types of certification: the 2014 edition and the 2015 edition.

    An EHR system is mandatory for ACI. If you don’t use EHRs, your ACI score will be 0%.

    Exemptions: Some clinicians are exempt from ACI. (See “Some Clinicians May Be Exempt From ACI.”)

    Calculating the ACI Score

    Add 4 Scores Together Contribution to ACI Score Mandatory or Optional?
    (1) Base score 0% or 50% Mandatory
    (2) + performance score 0%-90% Some measures mandatory; most optional
    (3) + registry bonus score 0% or 5% Optional
    (4) + CEHRT for improvement activities bonus score 0% or 10% Optional
    = ACI score 0%-100% Capped at 100%
    Your ACI score (0%-100%) contributes up to 25 points to your MIPS final score. For example, an ACI score of 80% contributes 20 points.

    Reporting at a Glance and Scoring Summary

    The minimum performance period is 90 consecutive days.

    There are 2 measure sets. If you have a 2014-edition CEHRT, you can use the 2017 ACI transition measure set; if you have a 2015-edition CEHRT, you also can use the ACI measure set.

    Four scores contribute to your ACI score: Base score, performance score, and 2 bonus scores.

    (1) Base Score

    Base score (0% or 50%) is mandatory. If your base score is 0%, your entire ACI score is 0%.

    Base score is all or nothing. To get the full 50%, successfully report all 4 base score measures from the 2017 ACI transition measure set (or all 5 from the ACI measure set); if you fall short, you get 0%.

    The reporting threshold is fairly low. For the Security Risk Analysis measure, you must report that you performed the analysis; for the other base score measures, report a numerator of at least 1.

    (2) Performance Score

    Performance score (0%-90%), is based on your performance rate for the measures that you report. For instance, the Patient-Specific Education measure can contribute 0%-10% to your ACI performance score. If you meet that measure’s requirements for 33% of applicable patients, you would score 4% for that measure.

    Mandatory or optional? Some performance score measures are also base score measures, and are therefore required; the rest are optional.

    If reporting the 2017 ACI transition measures set: Report on up to 7 performance score measures—2 are required (score 0%-20% for each) and 5 are optional (0%-10% for each).

    If reporting the ACI measure set: Report on up to 9 performance score measures—3 are required (score 0%-10% for each) and 6 are optional (0%-10% for each).

    (3, 4) Two Bonus Scores

    Registry bonus score (0% or 5%). You can get a 5% bonus if you report to the IRIS Registry.

    CEHRT for improvement activities bonus score (0% or 10%). If you use CEHRT functionality for an improvement activity, you earn points for your improvement activities score and a 10% bonus for your ACI score.

      2017 ACI Transition Measure Set (Recommended) ACI Measure Set
    Number of measures: 11 measures (download Table 11) 15 measures (download Table 12)
    You must report: 4 base score measures (2 of these also are mandatory performance score measures) 5 base score measures (3 of these also are mandatory performance score measures)
    You can choose to report: 5 optional performance score measures, 2 registry bonus measures 6 optional performance score measures, 4 registry bonus measures
    Can be reported using: 2014- or 2015-edition CEHRT or a mixture of the 2 if using modular approach 2015-edition CEHRT or a mixture of 2014- and 2015- edition CEHRT modules
    Provenance: Adapted from meaningful use program’s modified stage 2 measures Adapted from meaningful use program’s stage 3 measures

    For a deeper dive, see “ACI: Introducing Advancing Care Information.”

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    Next: Know the Basics: 5 Key Steps for Improvement Activities and ACI

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