Koby,
I think the questions that you are asking here are important, but rarely asked. I say that as someone who participated for 3 years and has now stopped. When the MU incentive program was announced, the $44,000 incentive was hard to ignore. The questions to ask were "how will my practice benefit and what will it cost me to get the 44k?" Every practice should do a calculation to decide if MU is right for them, or not.
For most people, that calculation included the cost of getting an EMR, which might be substantial (the entire $44k, in fact) but for those of us already with AC, this was not a significant factor.
My hope was that the program would lead to benefits in patient care. Investment of time and money in MU might be worthwhile if it leads to a better practice. That is a topic for another day, but suffice it to say that I have not seen the government mandates driving better patient care.
So the equation comes down to financial cost on one side vs. financial benefit on the other. The financial costs are software, hardware, and time. As stated above, we already have AC so lets assume that MU participation does not require additional investment in hardware or software (this is not entirely true, but lets assume it for now).
The pure dollar side of MU going forward consists of the penalties you would avoid. These numbers are constantly shifting, but the latest numbers indicate they would go from a 1-2% cut in 2015 up to 5% in 2020. Let call that an average of 3% a year over the next 5 years (
here is the chart). Of course you use your own practice numbers to calculate the impact. For example, if your practice gross is 350k (what some call an average gross) and 1/3 of that is from Medicare, your Medicare penalty will average about $3,500 per year. Not an insignificant amount of money; but it comes at a cost.
So what do you have to do to save the $3500, or $70 a week? You have to invest time; your own and your staff's. The amount of time is hard to quantify. One component is the time spent on each encounter (asking additional information and then entering it into AC). I would argue that
our time investment to understand MU is most significant. The hours spent following the changing timelines, penalties, rules, and regulations are tremendous. To understand what we must do and by when, to train our staffs, then to attest and potentially sweat out an audit; these all "cost" something. Maybe if you are in a large group, the time investment can be spread by having one doc who learns all the MU stuff and the others share the benefit. In a 1-2 provider practice, we don't have that luxury, though some are kind enough to share their knowledge here.
The decision is a personal one, and might be made on grounds other than a true cost-benefit analysis. I do think the analysis is worthwhile though. To me, it was worthwhile to participate the first few years, but now, with the smaller financial delta for participation, combined with the increased complexity of understanding and implementing MU2... I have bowed out. I am happy that I do not need to learn about MU2 or understand the intricacies of how AC records (or does not record) the various CQM's, or worry that I must have the most up to date version that allows for MU participation. I will use that time to improve my practice in other ways, to see one extra patient every week (to cover the $70/week), and to do some CME.
