I've also been playing around with accuracy, and right now at 99.89% the only misses I've seen in my parses are from hammer shot. I've also taken all the alacrity skills in both the combat medic tree (first responder) and the 4% skill in the assault tree, no additional alacrity on gear. The big difference I've seen is with FA channeling at 2.7 instead of 2.9 and a minimal change with grav round. Also, this does cause a need to watch your ammo a little more, but that's what the recharge cells and reserve power cells are for.