Altmetric works directly with about 24 academic publishers including Nature Publishing Group and Royal Society of Chemistry to integrate altmetric data and badges on their publications. Other organizations like ImpactStory also work with several publishers. Whether users care about altmetrics depends on the user type, with authors, editors, and librarians generally providing positive feedback, even when altmetric misses some data. How altmetrics data is presented impacts whether users interact with it, with click-through rates varying from 1% for small badges to 0.1% for links in sidebars. Key barriers for publishers adopting altmetrics include fears articles won't attract attention, lack of demand from authors and editors in some fields, and the costs of implementation.