By Dylan Scott

Governing

Feb. 9, 2012

Exchanges can be government-led (such as Indiana’s, one of the first HIEs, founded in 2004 by the state government) or provider-led (such as the one in Massachusetts, launched in 2004 by Blue Cross/Blue Shield at the urging of the state government). The specifics vary widely: As of 2011, 255 state, regional and metropolitan HIEs exist, according to Brookings.

But fundamental questions persist about their governance, compliance and financial sustainability. Overcoming those obstacles is imperative for long-term success, according to a Brookings panel that featured Claudia Williams, director of the state HIE program at ONC; Jon White, director of the health IT portfolio at the Federal Agency for Health Research and Quality (AHRQ); and Janet Marchibroda, chair of the health IT initiative for the Bipartisan Policy Center’s Health Project...

If the government incentivized quality outcomes and cost controls over sheer number of services performed (a policy already being tested in state Medicaid managed-care programs), providers would benefit financially from sharing information in an HIE. That would, in turn, lead to lower costs and better care for patients. Right now, compliance “doesn’t make sense from a business perspective,” Marchibroda said. “We’ve got to tackle that first.”

And more generally, Marchibroda said, policymakers and stakeholders must come to a mutual understanding about HIEs, as distrust and uncertainty has prevented some providers from joining or fully compiling with exchange efforts. In a recent survey of members of the Healthcare Information and Management Systems Society (HIMSS), only 45 percent reported that their organization participated in an exchange, according to Brookings.

Read the full article here

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Health IT Initiative, Health Project, Task Force on Delivery System Reform and Health IT