Providers Unwilling To Fund HIEs At Required Level
By Greg Bengel, contributing writer
As more providers participate in HIEs, questions about long-term funding makes sustainability a major problem for HIE organizations.
A group of researchers led by Julia Adler-Milstein from the University of Michigan recently published a study in Health Affairs (registration required) which assesses the progress of health information exchanges (HIEs) across the nation. The study finds that while HIEs show significant growth, most HIEs are unable to find sustainable business models.
Part of the problem, according to Adler-Milstein, is that providers are not willing to support and fund HIE’s at the level required. This Government Health IT article, which does a great job of summarizing the main points of the study, quotes Adler-Milstein on providers’ roles. “[Healthcare providers] don’t see enough value, and that’s because much of it doesn’t accrue to them,” she says. “It goes to patients and to health insurance companies. The central challenge is that the incentives and the business model are not aligned yet for this to really work.”
Despite the unwillingness to fund HIEs and the massive struggle on the part of HIE organizations to find sustainable business models, more providers are participating in HIEs than ever before. The study found that approximately 30 percent of hospitals and 10 percent of ambulatory practices are participating in an HIE. It also found this startling statistic: a full 70 percent of all HIEs surveyed reported long-term funding challenges.
For the majority of HIEs, grants from the HITECH Act are the main source of funding. Roughly $548 million was given to HIEs just to get them off the ground. That money will be running out by the end of the year. What then? According to Government Health IT, “Less than 25 percent of HIEs said they’re able to cover operating costs with revenue from participating providers and health organizations.”
According to EHR Intelligence, as the funding runs out, “Those exchanges that haven’t broadened their services beyond providing the plumbing for HIE are expected to go the way of the dodo barring some kind of miraculous development.”
The EHR Intelligence article references this recent study from the Robert Wood Johnson Foundation. The report emphasizes the fact that providers are disinclined to fund even the HIEs they participate in. According to the study, a lack of information on how HIEs deliver results and who is benefiting “results in a stalemate with providers who feel that they are being asked to shoulder the majority of the cost and payers and patients who are perceived as reaping the benefits from reduced redundancy and improved quality. However, payers are hesitant to support HIE efforts because they are uncertain whether they will be viable in the long run and feel that they have limited ability to ensure that providers use newly available data to make better care decisions.”