Subsidies aren’t enough to ease the financial pain of EHR transition for some docs. We’d all like to think that regulating electronic health records (EHR) is a good thing for everyone involved, patients and doctors, but it turns out that it’s not that simple.

Dr. Oliver Korshin is an ophthalmologist in Anchorage, Alaska, and after three decades in his small office, he’s seen patients move into Medicare coverage – he’s doing the same himself.

For Korshin and his practice, having patient’s medical records transitioned into an online database just isn’t practical because it will cost too much to install and maintain, according to him, and he’s pretty close to retirement anyway.

Unfortunately for him, the federal government will penalize Korshin for not using EHR starting next year by withholding 1 percent of his payments, and he’ll lose an additional 1.5 percent for failing to enroll in a federal program that requires doctors to digitally keep track of (and report) quality data about how their patients fare under their care.

That’s not all:

And then there’s the new coding system, also set to take effect in the fall of 2015 — an overhaul of the standard method of classifying diseases and conditions. Medicare and other insurers require the proper use of these codes if doctors want to get paid for the treatments and procedures they perform. A cost study sponsored by the American Medical Association earlier this year estimated that depending on “variable factors such as specialty, vendor and software,” implementing the new coding system alone could cost a small medical practice between $56,639 and $226,105. . .

This story is part of a reporting partnership that includes NPR, Alaska Public Media and Kaiser Health News

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