Jul 10, 2013 (09:07 AM EDT)
Healthcare Experts Watch For EHR Dropoff By Docs

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Of the doctors who attested to Meaningful Use of their EHRs in 2011, 20% failed to participate in the federal incentive program in 2012, according to an analysis of government data by the American Academy of Family Physicians (AAFP).

The number of family physicians who re-attested fell by 21%, from 11,578 in 2011 to 9,188 in 2012. However, the number of doctors who attested to Meaningful Use stage 1 for the first time last year soared to 23,635, a 180% increase from the prior year.

Robert Anthony, an official of the Centers for Medicare and Medicaid Services (CMS), addressed the decline in second-year attestations in a presentation on July 9 to the Health IT Policy Committee, according to Jason Mitchell, director of the AAFP's Center for Health IT.

Anthony told the committee that about a third of the "non-returners," as CMS describes them, were physicians who had simply missed the deadline to register for the second year of incentives, Mitchell said. "Most of the rest of these folks, according to CMS, either retired, moved to a practice that didn't have an EHR or had problems with the vendor or the EHR itself," he added.

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But Mitchell and Steven Waldren, senior strategist for health IT at the center, suggested other causes for the decline in an article in AAFP News. While missing the deadline was part of the problem, they said, so was the transition from a 90-day reporting period in 2011 to a full-year reporting period in 2012. Decreased funding for the regional extension centers (RECs) that helped many physicians adopt EHRs and attest to Meaningful Use might also have contributed to the drop-off, they said. The RECs only have to help enrolled physicians achieve Meaningful Use in the first year, not the second, under their government contracts.

In an interview with InformationWeek Healthcare, Mitchell said that the doctors who attested to Meaningful Use in 2011 but not in 2012 tended to be early adopters who were experienced in using EHRs. If these tech-savvy, committed doctors couldn't attest for two years in a row, he said, it raises questions about whether other, less committed physicians will remain in the program for Meaningful Use stage 2, even if they attested in both years of stage 1.

"There's a real possibility that the folks who have been able to re-attest may take their $30,000 in incentives and say, 'It's not worth the push into stage 2.' The change from stage 1 to stage 2 is going to be very significant. And I think we'll see a significant slowdown in the folks who remain attached to the Meaningful Use wagon."

Evan Steele, president of SRS Software, which makes a government-certified EHR for specialists, also wondered how many physicians would hang in there for the long run. Just in moving from the first to the second year of Meaningful Use stage 1, he told InformationWeek Healthcare, doctors had to collect data for a period four times as long for an incentive that was one-third smaller -- $12,000 in year two vs. $18,000 in year one.