Advanced Revenue Cycle Analytics: An Overview

Advancing Care Information, or ACI, is a simplified version of the retired Meaningful Use program.  Many of the most disliked MU requirements (CPOE, Clinical Decision Support) are no longer required.  The required elements of ACI focus on: ePrescribing, patient access to their chart, HIPAA security risk assessment and HIE.  Partial credit scoring is now available rather than the all or nothing scoring under MU. ACI is 25% of the aggregate MIPS score.

FIVE core ACI measures are required for a base score during the 2017 MIPS transition year in order for eligible clinicians to avoid the negative adjustment. The five measures are ePrescribing, Patient Access, Security Risk Assessment, Receive Transition of Care and Send Transition of Care.  For details on these measures as well as the details on the optional menu measures, visit the CMS MIPS site.


Much of the physician pushback during the “Meaningful Use Era” over the last 8 years, came from the heavy handed regulatory approach by CMS.  The structure of Meaningful Use, coupled with a compressed timeline forced physicians into workflows dictated by the federal government and EHR vendors.  The Meaningful Use measure thresholds were all-or-nothing. This means that even if you were only 1 encounter short on 1 Meaningful Use requirement, the practice or provider would miss 100% of the Meaningful Use incentive payment that year.  Another significant complaint about Meaningful Use was that the program did not make sense for many specialists/practice settings outside of Primary Care.  Finally, physician frustration reached an all-time high as physicians either spent more time doing data entry work themselves or hired additional staff (scribes) to meet Meaningful Use requirements that did not improve patient care.

Thankfully, the requirements under ACI are less restrictive than MU.  Eligible Clinicians participating in MIPS have the flexibility to choose the measures they want to participate in and that make sense to their practice.  Partial credit is also awarded, so that measures are not all-or-nothing.  The higher the score on each individual measure, the higher the score in the ACI category, and the higher the MIPS aggregate score.

Physicians have the opportunity to restore some sanity to their practice and regain control of how they participate in these programs.  By giving physicians the flexibility to exclude measures that do not add significance, but instead take valuable physician time from patient care, ACI allows physicians to  exclude certain measures without fear of losing all incentive money or of being automatically penalized with a negative adjustment.  ACI measurements that align with patient outcomes, patient satisfaction, and physician preferences help make provider participation not only logical but also beneficial.