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MIPS - ACI

This category, which represents 25% of the total MIPS score, replaced the Meaningful Use of Certified EHR Technology (CEHRT) incentive program.

ACI integrates the use of health information technologies in the context of care improvement. There are 3 components of this category:  Base score + Performance score + Bonus score.  The maximum achievable score is 100 points in this category.

The ACI score will be a composite of the following:

  • Base measures (worth 50 points of ACI score) – ECs or groups must report all required base measures to get any credit for ACI.  The number of measures depends on what CEHRT edition you are using.  All base measures are numerator/denominator or yes/no measures
  • Performance measures (worth up to 50 points) – You may choose up to 7 or 9 performance measures and points will be awarded based on performance compared to the benchmarks.
  • Bonus points (worth up to 15 or 25 points, depending on CEHRT edition) can be earned as follows:
    • 5 points for attesting to additional registries (in addition to the registry used for the performance score)
    • 10 points for attestation of Improvement Activity (using CEHRT)
    • 10 points for exclusive use of 2015 CEHRT

Below is the scoring for this category:

  • Base measures – worth 50 points of ACI score
    • All-or-none…must report all required base measures to get any credit for ACI
    • 4 or 5 measures depending on CEHRT edition
    • All base measures are numerator/denominator or yes/no measures
  • Performance measures – worth up to 50 points
    • Choose to submit from up to 7 or  9 measures (up to 90 points) for additional credit toward ACI score
    • Points awarded based on % met
  • Bonus credits – worth up to 15 or 25 points (depending on CEHRT edition)
    • 5 points for attesting to additional registries (in addition to the registry used for the performance score)
    • 10 points for attestation of Improvement Activity (uses CEHRT)
    • 10 points for exclusive use of 2015 CEHRT

Below is a summary of the requirements for this performance category:

Policy 2017 (Transition Year) 2018 (Year 2)
Measures Required 4-5 Base Measures (50%) Performance Score Measures Bonus points available

Base measures - no change

Some small changes to performance score and bonus point measures

Certification Requirements 2014 or 2015 Edition CEHRT

No change

10% bonus if using 2015 Edition CEHRT

Performance Period 90 days 90 days
Exceptions If not sufficient measures available for a clinician New 21st Century Cures Act exceptions
Weight 25% 25%

Depending on what level of certification a clinician or group is using, the required base measures are: 

If using 2015 CEHRT, there are 5 base objectives and measures:

  • Protect patient information through a security risk analysis
  • Electronic prescribing
  • Provide electronic patient access
  • Send a summary of care
  • Request and/or receive a summary of care

If using 2014 CEHRT, clinicians or groups can continue to use the transition objectives and measures:

  • Protect patient information through a security risk analysis
  • Electronic prescribing
  • Provide electronic patient access
  • Conduct transactions using health information exchange

Hardship exceptions for 2018, which must be applied for by December 31, include extreme and uncontrollable circumstances (e.g. storms, fires), lack of control over availability of CEHRT including EHR de-certification, small practices, and certain clinicians, such as non-patient facing, hospital or ASC based, NP, PA, CNRA or CNS.  In this case, the 25% ACI will be re-weighted to the Quality performance category.