According to this article the attestation rate from April 2011 to May 2012 was 12.2% overall; 9.8% for Specialists and 17.8% for Primary Care. For Ophthalomology it was 1100 out of 18,305 (2011 census) or 6%.
These rates are rather low in light of the fact that 72% of US physicians have EHR’s, see this link.
Reasons cited elsewhere are 1) attestation is an onerous process 2) Meaningful Use requirements are very disruptive of workflow 3) physicians continue to have difficulty with the transition to the EHR’s.
The British Journal of Ophthalmology gives the number of US Ophthalmologists in 2012 as 25,152; thereby giving an attestation rate of 4.37%. See this table. It’s worse than previously thought.
We had a customer with 21 radiologists attest for Stage 1 year 1 in 2012 and received a total incentive payment of $378,000.00 using OpenEMR as the certified system.
One of our other Radiology customers also got incentive payments for 30+, don’t know the dollars on that one though. We also had success with a Podiatrist and and 2 Ophthalmology Clinics.
Oddly none of our Primary Care folks bothered to try.
If there are 30+ Radiologists, in the second group, attesting for the first time for a 90 day period; it would be $540,000+ (30 x $18K).
What is the reason given by the Internal Medicine folks for not trying, especially given the fact that they have professional support? They don’t actually have to do the tracking and attesting themselves since both can be delegated to staff. They must think it’s Rocket Science or Quantum Mechanics. In fact it is easier for them than it is for Ophthalmology because they have fewer questions to answer.
One of my junior colleagues noted that an EHR conversion plus attestation would be so disruptive that there would be less revenue loss with the penalties.
In the case of my customers they are very small offices, 1 doc and 1 office person, usually the spouse. The process is perceived as over their heads/complicated and the cost of ‘consulting’ too high for the pay back. That is because they mostly don’t do Medicare or Medicaid patients, for the same reason, not profitable.
IMHO, attestation was designed to support the mega practices on behalf of the mega EMR vendors. It’s not reality for small, privately owned practices.
We have a 3 doc 1 PA Family Practice with lots of M-care and M-caid. My opinion: Attestation is a Royal Pain in the Ass that forced us to waste countless physician and ancillary hours and handicapped patient flow and quality of care. I did get an $18000 check (before taxes). I am envious of those who decided not to attest. (I was not using OpenEMR, but that would not have made the task less onerous.) Jack
If memory serves, it’s 75% of billed amount to Medicare, so a practice must have $24K worth of claims to get $18K. I did not bother looking at Medicaid attestation because of the 30% threshold requirement. I have only a sprinkling of Medicaid patients. If a practice does not accept Medicare, it can’t attest. No carrots but also no sticks.
It is very difficult for us not to accept Medicare patients; only Gerontology has more seniors than we do. Primary Care must have a large older population as well and I cannot imagine all those patients are able to opt out of using Medicare.
If the incentive had been designed for the “big boys”, it hardly comes as a surprise because they have more lobbyists than MI-Squared.
Attestation is not easy but do-able for the solo practice using OpenEMR. It was with this type of practice in mind that I wrote my 2 Wiki articles, one on DIY implementation of OpenEMR and the pictorial guide on attestation. It may or may not be valid to use my own practice as an example and it may be boosterism; but I think that if I can do it, the average physician can also.