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  • MIPS Manual 2017—ACI: Introducing Advancing Care Information

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

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


    The advancing care information (ACI) performance category replaces the meaningful use program for electronic health records (EHRs). It contributes up to 25 points to your 2017 MIPS final score.

    In 2017, There Are 2 Measure Sets for ACI

    You will report measures either from the 2017 ACI transition measures set (see “2017 ACI Transition Measures” or download Table 11 [PDF], an at-a-glance chart) or from the ACI measures set (see “ACI Measures” or download Table 12 (PDF), an at-a-glance chart).

    ACI’s 2 measure sets were carried over from the EHR meaningful use program. The 2017 ACI transition measures were adapted from the modified stage 2 measures and the ACI measures were adapted from the stage 3 measures.

    The set of measures that you can report depends on whether you have 2014- or 2015-edition CEHRT:

    • If your EHR system has 2014-edition certification, it will have the functionality to support reporting of the 2017 ACI transition measure set.
    • If your EHR system has 2015-edition certification, it will be able to support reporting of the ACI measure set and may be able to support the 2017 ACI transition measure set.
    • If you took the modular approach and have a mixture of 2014- and 2015-certified modules, you can choose either the ACI measure set or the 2017 ACI transition measure set, provided your EHR system is able to support the measures that you select.

    Pros and cons of the 2017 ACI transition measure set. This measure set has fewer measures than the ACI measure set and is therefore easier to report. However, if you want to achieve the CEHRT for improvement activities bonus (see “There Are 2 Bonuses Available”), there are more improvement activities that have related ACI measures than have related 2017 ACI transition measures (these are flagged in Table 7 [PDF], an at-a-glance chart of improvement activities).

    The Performance Period Is At Least 90 Days

    Pick a performance period of at least 90 consecutive days and no more than a calendar year. According to the proposed rule for the 2018 performance year, next year’s performance period will also be 90 days. Ultimately, however, CMS is planning to implement a 12-month performance period for ACI.

    There Are Different Levels of ACI Participation

    Under ACI, there is a base score and a performance score:

    • The base score represents a mandatory core level of participation.
    • The performance score involves a second level of participation where you are rewarded for your performance rate.

    You also can earn 2 bonus scores. You can get the registry bonus if you have integrated your EHR system with the IRIS Registry and are using its dashboard appropriately.

    The second bonus relates to how you perform in another performance category: Improvement activities. If you use CEHRT to achieve at least 1 improvement activity, you’ll earn an ACI bonus.

    Table 9: Calculating Your ACI Score

    Base score 0% or 50% Report 4 base score measures from the 2017 ACI transition measure set or 5 from the ACI measures set.
    + performance score 0%-90% Report up to 7 performance score measures (2 required; 5 optional) from the 2017 ACI transition measure set or up to 9 (3 required; 6 optional) from the ACI measures set.
    + registry bonus score 0% or 5% If you integrate your EHR system with the IRIS Registry, you can add 5% to your score by successfully reporting a registry bonus measure.
    + CEHRT for improvement activities bonus score 0% or 10% If you use CEHRT functionality to complete an improvement activity, that activity will contribute to your improvement activities score and add 10% to your ACI score.
    = ACI score 0%-100% Your ACI score is capped at 100%.
    Your ACI score contributes up to 25 points to your MIPS final score (0-100 points). For instance, an ACI of 80% contributes 20 points to your MIPS final score.

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    Next: ACI: First, Meet ACI’s Base Score Requirements

    Note: Meeting regulatory requirements is a complicated process involving continually changing rules and the application of judgment to factual situations. The Academy does not guarantee or warrant that regulators and public or private payers will agree with the Academy’s information or recommendations. The Academy shall not be liable to you or any other party to any extent whatsoever for errors in, or omissions from, any such information provided by the Academy, its employees, agents, or representatives.

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