The Medical Group Management Association's point man in Washington, D.C., says most of the groups the MGMA represents would not be eligible for government incentives for adopting and using an electronic health record by 2011.

There are too many issues to resolve in too short a time, said Robert Tennant, the association's senior policy adviser, who is attending the MGMA's annual conference in Denver this week. Tennant focuses on federal legislative and regulatory health information technology issues.

Physicians stand to gain $44,000 in government incentives over five years under the economic stimulus package if they show meaningful use of healthinformation technology. The definition of "meaningful use" is still in the making, and many industry experts advise physicians without an electronic health record in place to start now in order to be eligible for incentives.

The MGMA has 22,500 members, most of them administrators and managers at more than 13,700 medical groups across the country.

"Our members are in two camps," said William F. Jessee, MD, About a fourth of them have some form of EHR, he said. They are interested in what the rules are going to be and how they can get the most from the incentives.

The remaining 75 percent have not made an investment yet, he said. And, he noted, all medical groups are grappling with the effects of the recession.

Medical practice revenue declined across the board in 2008, and multi-specialty groups saw a 1.9 percent decrease in total medical revenue, he said; there was also a 9.9 percent drop in patient procedures and an 11.3 percent drop in the number of patients from 2006-2008, while bad debt charges increased 13 percent.

"In 10 years, it's the first time we've seen that kind of negative growth in the industry," Jessee said.

As a result, he said, nearly 37 percent of MGMA members said they have postponed capital expenditures – a move that could affect whether they adopt an electronic health record system.

Rosemarie Nelson, a principal of the MGMA Health Care Consulting Group, said the government incentives have created "tremendous buzz," but there is also "a lot of confusion."

She said physicians and practice administrators have asked her: "Where do I sign up for the check so I can buy my system?"