What is the ACI Performance Category?

Description

The Advancing Care Information performance category is the MIPS replacement for Meaningful Use. Its purpose is to encourage providers to utilize electronic health records and other technology systems to improve care delivery.

For 2017, there are two sets of ACI measures. They are:

  • Option 1: Advancing Care Information Objectives and Measures
  • Option 2: 2017 Advancing Care Information Transition Objectives and Measures (“transition measures”)

A provider must report on only one of these, and the one selected will depend on the provider’s specific EHR. A provider using an EHR certified to the 2014 CEHRT edition must use the transition measures set. A provider using an EHR certified to the 2015 edition may choose either option.

In 2017, hospital-based MIPS clinicians, nurse practitioners, physician assistants, clinical nurse specialists, and CRNAs who report as individuals (see Reporting Considerations) can elect not to report ACI measures, in which case the 25% category weighting is added to the Quality performance category.

ACI Scoring: Basics

A perfect score in the ACI category is 100 category points, which translates to 25 MIPS CPS points. Points are earned by completing different types of measures. Within each measure set, there are three types of ACI measures:

  • Base measures are mandatory. Failure to complete any base measure results in failure of the entire ACI category and a corresponding ACI category score of zero. Satisfactory completion of all base measures earns a score of 50 category points.
  • Performance measures are opportunities to earn up to an additional 90 category points. These are not mandatory, and category points are awarded pro rata based upon the level of performance. For example, if a performance measure has 10 category points available, and a provider reports a performance rate of 80%, then that provider would earn 8 category points for the measure.
  • Bonus measures are opportunities to earn bonus category points. Some of these are only accessible if the Immunization Registry Reporting performance measure is met.

Note that there are more than 100 category points possible in the ACI performance category, but the category score is capped at a maximum of 100.

ACI Scoring: Option 1

ACI Objectives and Measures
  Measure Minimum performance requirement Category points available
Base Measures Security Risk Analysis Conduct a security risk analysis 50 category points for completing all requirements
No "partial credit"
Overall category score of 0 if any requirements are not completed
e-Prescribing Transmit at least one prescription using certified EHR technology
Provide Patient Access* Provide at least one patient with access to view online, download, or transmit their heath information
Send a Summary of Care* Create and electronically transmit at least one summary of care record to a receiving health care clinician using certified EHR technology
Request/Accept a Summary of Care* For at least one patient, receive and incorporate into the patient’s record an electronic summary of care document
Performance Measures Provide Patient Access 10
Send a Summary of Care 10
Request/Accept a Summary of Care 10
Patient-Specific Education 10
View, Download, or Transmit 10
Secure Messaging 10
Patient-Generated Health Data 10
Clinical Information Reconciliation 10
Immunization Registry Reporting@ 10
Bonus Measures Syndromic Surveillance Reporting@ 5
Electronic Case Reporting@ 5
Public Health Registry Reporting@ 5
Clinical Data Registry Reporting@ 5
Completion of one or more Clinical Practice Improvement Activities using CEHRT@ 10
Total available category points 170
*These base measures also appear as performance measures, e.g. additional category points are available for performance exceeding the minimum performance requirement.
@These measures are "all-on-none," i.e. no partial credit is awarded.

ACI Scoring: Option 2 (Transition Measure Set)

ACI 2017 Transition Measure Set
  Measure Minimum performance requirement Category points available
Base Measures Security Risk Analysis Conduct a security risk analysis 50 category points for completing all requirements
No “partial credit”
Overall category score of 0 if any requirements are not completed
e-Prescribing Transmit at least one prescription using certified EHR technology
Provide Patient Access* Provide at least one patient with access to view online, download, or transmit their heath information
Health Information Exchange* Create and electronically transmit at least one summary of care record to a receiving health care clinician using certified EHR technology
Performance Measures Provide Patient Access 20
Health Information Exchange 20
View, Download, or Transmit 10
Patient-Specific Education 10
Secure Messaging 10
Medication Reconciliation 10
Immunization Registry Reporting@ 10
Bonus Measures Syndromic Surveillance Reporting@ 5
Specialized Registry Reporting@ 5
Completion of one or more Clinical Practice Improvement Activities using CEHRT@ 10
Total available category points 160
*These base measures also appear as performance measures, e.g. additional category points are available for performance exceeding the minimum performance requirement.

@These measures are “all-on-none,” i.e. no partial credit is awarded.

How to Report

ACI measures are reported by attestation, just as Meaningful Use measures were reported. Attestation can be completed via registries and EHRs that support CPIA attestation or directly on the CMS web portal. It is important that providers maintain an evidence file throughout the year to ensure there are data to support the attestation process.