Understanding New Advancing Care Information (ACI) Measures

[Randal Roe (Alpha II Registry)]

We're trying to understand a seeming discrepancy in the number of ACI measures. The Advancing Care Information page on the QPP website, https://qpp.cms.gov/mips/advancing-care-information, shows these counts:

• 15: ACI Objectives and Measures
  
• 11: 2017 ACI Transition Objectives and Measures
  
• 26: Combined
  

However, the qpp-measures-data page (we’re looking at measures-data.json) on the CMS GitHub site, https://github.com/CMSgov/qpp-measures-data/blob/master/measures/measures-data.json, shows these counts:

• 22: ACI Objectives and Measures
  
• 13: 2017 ACI Transition Objectives and Measures
  
• 35: Combined
  

Within the “Developer Group for QPP APIs,” the last comment on this page, https://groups.google.com/d/msg/qpp-apis/BnLEZ2cYDPA/nVNgsxkoAgAJ, points to a shared spreadsheet, https://docs.google.com/spreadsheets/d/1qelEpmtsKpk8U3D72HerdIxXQebnK-jYcyLV8hZijXs/edit#gid=6704706, that shows these counts:

• 22: ACI Objectives and Measures (Normal Track tab)
  
• 17: 2017 ACI Transition Objectives and Measures (TransitionTrack tab)
  
• 39: Combined
  
• 4: LESS same new measures on both tabs (to avoid double-counting)
  
• 35: Actual combined
  

Analysis: These seem to be the new measures — that is, measures that cannot be obtained from selecting all “regular” or transition measures from https://qpp.cms.gov/mips/advancing-care-information:

• 3: ACI Objectives and Measures
  
• ACI_LVITC_1: Low-Volume Incoming Transfer of Care
• ACI_LVOTC_1: Low-Volume Outgoing Transfer of Care
• ACI_LVPP_1: Low-Volume Permissible Prescriptions
• 2: 2017 ACI Transition Objectives and Measures
  
• ACI_TRANS_LVOTC_1: Low-Volume Outgoing Transfer of Care
• ACI_TRANS_LVPP_1: Low-Volume Permissible Prescriptions
• 4: Common measures — used for both “regular” and transition measure sets
  
• ACI_IACEHRT_1: CEHRT Used
• ACI_INFBLO_1: Prevention of Information Blocking Attestation
• ACI_ONCACB_1: ONC-ACB Surveillance Attestation (Optional)
• ACI_ONCDIR_1: ONC Direct Review Attestation
• 9: Combined
  

This combined total of 9 equals the difference between the new actual combined count (35) and the previous combined count (26). That makes sense.

• Question 1: Would you please confirm the above understanding?
  
• Question 2: Would you please confirm that the following new measures are required measures — that is, that they must have a value of “true” or else there is no score for the ACI performance category:
  
• ACI_INFBLO_1: Prevention of Information Blocking Attestation
• ACI_ONCDIR_1: ONC Direct Review Attestation
• Question 3: How should we as a qualified registry and our clients use the new “Low-Volume” measures?
  
• Question 4: Will the new measures be documented anywhere? If so, where?
  

Thank you.

Randal Roe

Alpha II Registry

[Ivana Ng]

Hi Randall -

I've made some comments below in red. Hope this helps.

• 3: ACI Objectives and Measures
  

• ACI_LVITC_1: Low-Volume Incoming Transfer of Care
• ACI_LVOTC_1: Low-Volume Outgoing Transfer of Care

• ACI_LVPP_1: Low-Volume Permissible Prescriptions
  
  These are proposed, not finalized. We have updated the names of these measures in https://github.com/CMSgov/qpp-measures-data/blob/master/measures/measures-data.json to indicate that they are proposed, not finalized.
  
  

• 2: 2017 ACI Transition Objectives and Measures
  

• ACI_TRANS_LVOTC_1: Low-Volume Outgoing Transfer of Care

• ACI_TRANS_LVPP_1: Low-Volume Permissible Prescriptions
  
  These are proposed, not finalized. We have updated the names of these measures in https://github.com/CMSgov/qpp-measures-data/blob/master/measures/measures-data.json to indicate that they are proposed, not finalized.

• Question 2: Would you please confirm that the following new measures are required measures — that is, that they must have a value of “true” or else there is no score for the ACI performance category:
  

• ACI_INFBLO_1: Prevention of Information Blocking Attestation - This is required to obtain a score for the ACI category and is attesting that the practice has not participated in Information Blocking. Additional information on this attestation can be found in the Final Rule.
• ACI_ONCDIR_1: ONC Direct Review Attestation - This is required to obtain a score for the ACI category and is attesting that the user will participate in good faith on any ONC Direct Review request. Additional information on this attestation can be found in the Final Rule.

• Question 3: How should we as a qualified registry and our clients use the new “Low-Volume” measures?
  
  

• These measures are proposed, not finalized. When CMS does finalize these measures, you will be able to submit them and have them count toward your ACI score. We don't yet have a date on whether or when these measures will be finalized.

• Question 4: Will the new measures be documented anywhere? If so, where?
  
  

• They will be documented here: https://github.com/CMSgov/qpp-measures-data/blob/master/measures/measures-data.json
  
  They are also referenced, as "proposed" measures, in the 2017 QRDA III implementation guide: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/eCQM_QRDA_EC.pdf
  

Ivana Ng

Product Manager

Nava

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[Shane Jarrell]

This answers my question about ACI score 0. Thanks Randal and Ivana.

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