The actual size of the meaningful use bible is 864 pages now. It was written by a group of EMR vendors headed by John Glaser (
http://histalk2.com/). To try to get the $44000.00 you need to satisfy each and every criteria 100%. Your losses in productivity and in the reporting process will be massive. Good luck to anyone that tries it. You can count me out. When the penalties begin to fly, I'll be out of Medicare altogether.
My only worry is that MU will mutate and be adopted by private insurance companies. At that point you'll see small physician offices fold and doctors in general will become employees of massive group practices. Healthcare will be truly changed forever...