17% Meaningful Use Dropout Rate—Just the Tip of the Iceberg

17% Meaningful Use Dropout Rate—Just the Tip of the Iceberg

My last EMR Straight Talk post, which addressed the alarming 17% meaningful use dropout rate, generated many comments and resulted in several subsequent media interviews. While CMS has acknowledged the facts regarding this program failure, it does not acknowledge the gravity of the implications for the future of the program. According to a Bloomberg News article, CMS attributes the fallout to many of the same reasons that I have identified from the outset—program complexity, lack of fit with specialty practices, cost, dissatisfaction with EHRs, and inability to meet the meaningful use requirements.

To evaluate the program’s future, it is necessary to understand why physicians participate in meaningful use to begin with, and what their motivation would be to continue to participate once they have purchased a certified EHR and recouped $18,000 of its cost. A simple financial analysis begs the question: Why would physicians do dramatically more work for significantly less money?

One only has to look at the math to predict the future. As the table below illustrates, the financial value of the incentives drops by a factor of 10 at the same time that the program requirements increase precipitously. If 17% of physicians abandoned the program when the incentives fell from $6,000 to $1,000 per month of meaningful use effort, what should we realistically expect to happen when the incentives drop even further and the complexity increases?

Total $ Value of Participating in the EHR Incentive Program


*Estimate based on annual Medicare revenue of $300,000. Penalty = 1% in 2015, 2% in 2016

I am certainly not saying that physicians are only motivated by money—of course they want to do the right thing and provide the best possible care for their patients. And shunning meaningful use does not preclude them from leveraging their certified EHRs to exchange clinical data with other providers. But physicians have been quite outspoken about their concerns from the beginning, expressing their perception of the program as overly burdensome, wasteful, and distracting from their mission to provide that care. Now, the evidence is in—they are not just speaking, but they are walking. Clearly, to ensure the ongoing success of meaningful use, the government must fundamentally reduce the program’s complexity.

One thought on “17% Meaningful Use Dropout Rate—Just the Tip of the Iceberg

  1. In my work with many best of breed /niche vendors going through the ONC Certification process a similar result is happening. The test criteria have expanded by orders of magnitude and many are delaying 2014 Certification (some talking about skipping it altogether). Just look at the number of fully certified EHRs on the CHPL website six months after the 2014 Criteria were published. The numbers are way down, and keep in mind that all S1 certified products die at 9/30 or 12/31 per ONC rules.
    Even major inpatient vendors who have extensive resources to aply to certification are not 2014 approved yet.
    Frank Poggio
    The Kelzon Group

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