In looking over what Jon has proposed I see value in most of those items.
P4P is not loved by many, but if you must do it, automating it in AC is very valuable. There can be value in creating checklists to ensure that you have completed all the items on a patient, but the devil IS in the details. Will it have to be manually populated or will it pull information from other sources? If it is too cumbersome, we won't use it. I don't currently use the immunization section.
If you truly want to go paperless, you need to verify that all the needed paperwork has been done, so this would be useful as well.
As a pediatrician, I have little need for all of the current MidMark bloat, but I understand the need for it to be there for most.
You can always stick with version 3

But really, most changes in version for AC have been evolutionary not revolutionary.
Sure, the more add ons you make, the more things to break. They do an amazing process of making a stable product.