>>> P4P is not loved by many, but if you must do it, automating it in AC is very valuable.

Actually, Wendell, P4P is a dead end for AC (as for most EMRs) since Medicare only is allowing those offices with CCHIT-certified EMRs to participate. Jon knows that and will most likely focus on other matters, s.a. the new MS SQL backend.

Eventually, most P4P initiatives, whether governmental or insurance industry associated will follow Medicare's lead. What needs to be done is for physicians to form a focus group to sue to get the right to participate with P4P (if you want to, of course) in any which way, including using paper records. I don't see how this situation, where government is actually destroying EMR competition and physician freedom of choice can win out at the end.