ACP Is Infrastructure. If It’s Not in Your EHR, You’re Already Behind.

Patient Goals and Preferences. Whenever and Wherever Care Happens

By Ron Wozny
Senior Vice President, Marketing & Business Development
MyDirectives

CMS said something big this month: Advance care planning (ACP) is infrastructure.

That may sound like policy jargon, but it signals a fundamental shift. One that pushes ACP out of the “nice to have” category and into the realm of operational necessity.

And when something becomes infrastructure, it has to live inside the systems that already power care delivery. That starts with the electronic health record (EHR).

At MyDirectives, we’ve known for almost two decades that the only scalable, sustainable way to make ACP work is to embed it directly into clinical workflows, not as a bolt-on, and not buried in the back end of a patient portal. And health systems using leading EHRs already know this. We’re helping hospitals, health systems, and states build ACP into the everyday fabric of care by integrating directly into the EHRs they rely on: Epic, Oracle Health, MEDITECH, PointClickCare, KanTime, and others.

When ACP is embedded like this, it’s easier for clinicians and non-clinician team members to complete documentation, easier for interdisciplinary care teams across all points of care to find and follow it, and easier for systems to meet evolving compliance and electronic clinical quality measure (eCQM) requirements — including what’s coming next.

CMS Is Putting ACP on the Scorecard

If you’re tracking regulatory signals, here’s one to watch: the 2025 CMS Measures Under Consideration (MUC) list includes two new proposed measures—MUC2025-020 and MUC2025-011—focused on ACP and other patient life goals discussions and documentation. That means ACP is on track to become not just infrastructure, but infrastructure that’s measured, audited, and tied to reimbursement.

Hospitals, health systems, and other healthcare providers still relying on disconnected forms, outdated portals, or static PDFs will find themselves out of step with CMS, with peers, and with patient expectations.

Policy Support Is Building

Federal legislation is moving in parallel. Two bipartisan bills — both of which we support — are designed to expand access and remove barriers to effective ACP that actually moves the needle:

• The MAP for Care Act, introduced by Senators Bill Cassidy (R-LA) and Chris Coons (D-DE), recognizes that ACP only works if advance directives and surrogate decisions are digitally accessible across the entire health system, in real time, whenever and wherever needed.
• The Improving Access to Advance Care Planning Act, introduced by Senators Mark Warner (D-VA) and Susan Collins (R-ME), would eliminate cost-sharing and expand billing eligibility for ACP conversations, unlocking access for millions of Medicare beneficiaries.

But passing good policy isn’t enough. We need implementation infrastructure that works. That’s where MyDirectives comes in.

From Policy to Practice: ACP That Scales

Through MyDirectives for Clinicians™, care teams can complete, view, and update ACP documentation, including portable medical orders, directly inside their EHR with no separate logins or systems. And once those preferences are documented, they’re automatically routed to the A|D Vault Exchange™, our nationwide, HIPAA compliant, HITRUST and TX-RAMP certified, and SOC 2 Type II audited ACP document registry, where they can be accessed across care settings whenever and wherever they’re needed.

That includes Emergency Medical Services (EMS), including Mobile Integrated Health (MIH) teams and community paramedicine. It includes long-term care and home-based care. And increasingly, it includes statewide ACP ecosystems in states that are investing in connected, modern infrastructure to make sure ACP documents and portable medical orders are accessible in every care setting.

Healthcare providers using EHRs not yet supporting integrated ACP tools or “farming out” their ACP to third-party vendors unable to support both legislative and regulatory compliance and eCQM reporting, risk being left out of these emerging statewide, regional, and national initiatives. They also risk losing relevance and missing bottom-line financial targets as CMS moves from guidance to enforcement.

The Time to Act Is Now

Whether driven by federal legislation or regulation, state policy, financial performance, clinical quality, or common sense, the shift is happening. ACP is being treated as infrastructure because that’s what it is: foundational to delivering the right care at the right time, in alignment with patient goals and values.

If you’re still relying on fragmented workflows, manual uploads, or missing documentation, or if you’re ignoring ACP altogether due to technology and workflow challenges, it’s time to level up. Because CMS isn’t just hinting at the future. They’re building the framework now.

Let’s make sure you’re ready.

If you’re building ACP infrastructure in your health system, HIE, or state, we’d love to talk.

About the Author
Ron Wozny is Senior Vice President of Marketing and Business Development at MyDirectives, where he leads brand strategy, growth initiatives, and strategic partnerships focused on advancing digital advance care planning at national scale.

With more than two decades of experience across healthcare marketing, business development, and sales operations, Ron has built and scaled brands in complex, regulated markets. Before joining MyDirectives, he served as Senior Vice President of Marketing and Sales Operations at HealthSmart, where his integrated growth strategies helped drive 80% revenue growth over five years. He has also held senior marketing leadership roles at Healthx (now mPulse), ZeOmega, T-System, and VHA (now Vizient).

Ron holds an MBA in Marketing from Regis University and a Bachelor of Journalism degree from the University of Nebraska–Lincoln.