I too decided not to pursue MU. While the incentives were tempting, I looked ahead (as best as I could a few years ago) and reckoned meeting MU part 2 would be extremely difficult, so pursuing the first incentive would not be honorable (I come from the military). I also wondered if there might be an additional penalty, or call for return of funds, if one failed to complete the full MU process. I estimate I will sacrifice at most $5000 a year. Not chump change, yet a decent trade off given the need for extra documentation and compliance monitoring (for MU) which doesn't seem to add a lot to the quality of the care provided.