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!