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  • MIPS Manual 2017—ACI: MIPS Versus MU

    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.


    ACI evolved out of the EHR meaningful use (MU) program, and CMS deliberately tried to preserve a high degree of continuity—though you will notice some welcome changes.

    MU had been ratcheting up the reporting requirements, but ACI introduces some flexibility. Under ACI, reporting thresholds have largely been eliminated. Reporting thresholds do still apply for the base score measures, but they are set at a fairly low level (for instance, the requirements for the Provide Patient Access measure have to be satisfied just 1 time for 1 patient).

    The ACI requirements differ from the MU requirements in several other respects, including the following:

    • Measures related to MU’s Clinical Decision Support and Computerized Provider Order Entry objectives have been eliminated, which means scribe certification is no longer required.
    • The patient portal measures—Secure Messaging and View, Download, and Transmit—are now optional.
    • Clinical quality measures are not reported for the ACI performance category, though you will still report them for the quality performance category.
    • You can report ACI measures either as an individual or as part of a group. In contrast, for the EHR meaningful use program, you could only report as an individual. You must report in the same way (as an individual or a group) for all 3 reported performance categories (ACI, quality, and improvement activities).
    • You have more options for reporting ACI measures—as with MU, you can report via a CMS web portal, but you also can report via the IRIS Registry or EHR vendors.

    Meaningful use lives on in Medicaid. Although Medicare’s MU program evolved into MIPS’ ACI performance category, Medicaid continues to operate a state-specific MU program. Unfortunately, MIPS participants can’t kill 2 birds with 1 stone—attesting for Medicaid’s MU program does not count toward your ACI attestation requirements; similarly, your ACI attestation does not count toward your Medicaid MU attestation.

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    Next: ACI: 2017 ACI Transition Measures

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