Potential Medicare Exodus and EMR Stimulus Penalties

The idea that there will be penalties is a joke. The ongoing (10 years and counting) SGR debacle has thoroughly disgusted physicians who have already begun to reduce or completely eliminate Medicare patients from their practice. If Medicare starts to nickel and dime those still willing to take Medicare patients – for not using e-prescribing, not participating in PQRI (which is cash-negative for those who participate) or not implementing EMR, they’re even dumber than they’ve already demonstrated.

Pile on 5010 implementation, ICD-10 CM implementation, another ongoing PECOS fiasco, the interminable MAC transitions, RACs, PERMs, Z-PICs, HEAT, etc. and Medicare (or Congress) thinks a penalty will motivate physicians to buy new software – or that the doctors will tolerate a payment reduction when their 2010 payments are LESS than their 2000 payments?

I can’t remember where I found this quote. Probably on a LinkedIn forum or something. This voice is actually getting louder. Notice that it doesn’t really talk about whether they want to use EMR software or not. It’s really the start of what could be a huge exodus from Medicare as opposed to a revolution against EMR software. Plus, it highlights the fact that doctors (and people in general) don’t want to be forced to do something. Yes, even something that could be a benefit to them. Of course, that’s why I’ll keep telling doctors to not worry about the stimulus and the penalties and focus instead on the list of EMR benefits.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Unfortunately there’s a ring of truth in this voice and your analysis. It has to do with fight or flight: the perception of being backed into a corner will spark strong reactions, even if you really are trying to help. The problem is that many in health care just don’t see the personal value in these programs.; nevermind the larger goals, providers need to need how an EHR is going to help solve their specific, local problems. If it can’t, or doesn’t appear to even address what their experiencing, then expect more of the same reaction.

  • Michelle… You are close to this issue too… but is it that…

    “many in health care just don’t see the personal value in these programs; nevermind the larger goals”

    …because the programs they are having to submit to have not proven work… plus practitioners are tired of the little carrot = BIG STICK approach coming out of HHS on every single item?

    Even Mayo Clinic Arizona in a test has dropped services to 3000+ Medicare patients of one of its PCPs in Glendale. Test is being undertaken by Mayo due to the huge Medicare losses it has incurred because seniors have easy access to the secondary care facility via direct referral from their family medicine practitioner. By dropping the Medicare patients Mayo believes it will be easier to not accept referrals from non-Mayo PCPs for services in its medical center… saving money and stepping away from the Medicare slide.

    But your point is good about EHR adoption regardless of whether the practitioner continues to contract with CMS. The item last week about how private carriers will interface with or employ MU is a hint on whether there is a private reason to implement.

    You may have been the one who asked about other places and how they are addressing EHR adoption.

    In the UK there is near total EHR adoption by the private primary care sector. They did it for their own benefit with no government stimulus in order to improve their practices. Contrary to the results in the private sector in the UK … NHS’ primary care surgeries set up to fill the holes where the private providers could not cover the population … and the NHS secondary care facilities has been a total disaster. Since they are all identical … clearly NHS didn’t read the VA’s book.

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