Alarming Fact: Meaningful Use Dropout Rate at a Staggering 17%

Alarming Fact: Meaningful Use Dropout Rate at a Staggering 17%Here’s an alarming fact: the meaningful use dropout rate is already 17%.

A recently published assessment of the government’s April EHR attestation data revealed that 17% of the providers who earned an $18,000 EHR incentive in 2011 did not earn the $12,000 second incentive in 2012. Although the analysis was performed by the venerable Wells Fargo, my immediate response was, “That’s impossible! They must have miscalculated the data.”

So I crunched the numbers for myself, and to my astonishment, the conclusion is absolutely correct. A staggering 17% of the providers who succeeded at demonstrating meaningful use for 90 days were unable to sustain that performance for a full year—the second required reporting period—despite the fact that the program’s requirements remained exactly the same and the providers already had the necessary workflows in place to support those requirements. What makes this fact even more troubling is that the 2011 attesters were typically the early EHR adopters and therefore most experienced in the use of the technology.

A 17% loss rate in any business is wholly unacceptable, and this failure does not portend well for the future of the EHR Incentive Program. If $12,000 proved to be insufficient motivation for physicians with meaningful use experience to meet the relatively low requirements of Stage 1 on an ongoing basis, it would be foolish to expect physicians to muster the wherewithal to meet the increasingly demanding requirements of Stage 2. The incentive for a year’s performance at that point will be a mere $4,000.

Compounding this finding is the fact that 14% of physicians who attested to Stage 1 have already stated that they have no intention of attesting to Stage 2, according to another recent survey. And we can be sure that this number will rise as physicians begin to familiarize themselves with the labyrinthine requirements. If physicians are not motivated by the remaining incentives, it’s equally clear that the imposition of penalties for noncompliance will yield no better results. There is already a groundswell of objections to the penalties, including a bill introduced in the House seeking numerous exemptions, letters from AMA and AHA, etc.

So, is this the beginning of the end of meaningful use? What is keeping physicians from continuing to participate in the program? Are they bailing or failing? In either case, it is just too complicated—physicians are demonstrating that they are not willing to divert their attention from treating patients to consistently devoting the time necessary to keep track of the myriad measures on which they must successfully report. Instead of making meaningful use increasingly complex, we need to simplify it—focus on interoperability and leave the physicians and their clinical staffs to practice medicine. If we do not, the entire program will go down the drain. Let’s not throw the baby out with the bathwater!

10 thoughts on “Alarming Fact: Meaningful Use Dropout Rate at a Staggering 17%

  1. You are 100% correct. We have no intention of doing Phase 2. For a sub-specialty orthopedic practice, some of the Phase 2 measures are just not achievable even if we wanted to pretend this was all ultimately worthwhile.

    We will support a regional HIE underway, but take our lumps if they want to ding us in a couple of years…. I’m betting no one gets penalized


  2. I agree. Leave the physicians and their clinical staff to practice medicine. These penalties need to go also.
    We are a solo Dermatology office, these requirements and these penalties, are about to drive our Dr. to retirement. This would be a sad day for this rural town.

  3. I have no intention of playing the EMR game. Does not help me take better care of patients. Does not help me communicate better with other physicians. And it is a money loser.

  4. We plan on satisfying meaningful use as long as our EHR vendor updates our software to capture the required data.
    If our government desires certain information, they should regulate EHR vendors to incorporate code into the software to capture this data so physicians offices do not have to spend numerous hours doing this. Medical practices are struggling enough with reduced reimbursement, increased expenses, and the many new government mandated compliance and regulations to have time to deal with collecting data to satisfy meaningful use, PQRS and other data collection requirements that carry penalties if we do not supply the data to our government. EHR vendors can write code to capture and submit this data much more efficiently than physician offices, who are already over-taxed.

  5. What is being lost in this whole exercise is the need to find the “sweet spot” in the trade off between flexibility and structure. Too much structure leads to a diminution of individual intelligence. Too much flexbility leads to collective choas. There needs to be a simple and elegant middle ground or “sweet spot” where collective data in EHRs can lead to quality care and reduced expenses while preserving the individuality of the patient-physician interaction.

  6. Show me something in meaningful use that is designed to improve a physician’s life? For every thing you can show me I can show you 10 that make it harder. They might be good things for the patients. They might be good things for healthcare in general (which in some ways benefits the doctor), but meaningful use is not meaningful to doctors. This is a big mistake on the part of MU and explains why you’re seeing what you described.

    I’ll be surprised if the penalties go into effect too. That is a compelling thing for some doctors.

  7. Does anyone find this surprising?

    Here’s what’s needed for meaningful use:
    1. 15 core objectives
    2. 5 out of 10 from menu set objectives
    3. 6 total clinical quality measures
    3 core or alternate core
    3 out of 38 from additional set

    Put simply, $12,000 is 1-2% of collections for a busy physician. If the work load goes up by even 10% because of the extra burden of documentation, you’re losing money and would be better off using that time to see more patients.

  8. While Stage 2 focuses more on information exchange and patient engagement, many large EHR systems have this type of functionality built into their software, making it easier to achieve compliance. Also, for those eligible providers who have successfully attested to Stage 1, meeting Stage 2 should not be as difficult, as it builds incrementally on the requirements for the first stage.

  9. You’re asking some good (and necessary) questions here. We’ve looked at this from the hospital perspective. While implementing EHRs definitely poses a lot of challenges for providers, there are some who are managing it successfully: What do you think healthcare providers need to do to excel at using electronic records?

  10. 83% staying on and going to stage two is pretty good. I would guess that at least half of the 17% have systems that are not capable of an easy transition to stage two. Even approved systems are problematic unfortunately in the US providers world of EMR’s are still in the Wild West stage and are not as competent as the providers who use them nor the DOH who are looking to improved health and lower overall costs

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