State health information exchange organizations will have their work cut out for them with changes in payment mechanisms regardless of whether the healthcare reform law survives legal and political challenges, according to a report by an advisory panel to the Healthcare Information and Management Systems Society. Meanwhile, the panel wrote, funding and the hunt for sustainable business models will remain a concern for many state HIEs.
Info exchanges need to adapt: HIMSS panel
The 15-page report from the HIMSS State Advisory Roundtable, "States Will Transform Healthcare Through Health IT and HIE Organizations" (PDF), asserts that statewide health information exchanges "need to be prepared to adapt their business models as federal and state reform policies, but also private payers, move from fee-for-service to pay-for-quality reimbursement models."
At the same time, according to the panel, state-sponsored health information exchanges are under heightened competitive pressure from "private options that are emerging as market organizers." With few state HIEs as exceptions, the panel stated, "the state-level business model is almost completely void of private investment."
As demands for care coordination, telehealth services, quality and payment analytics increase, "the business of state HIEs will likely need to shift from 'facilitator of sharing' to 'data aggregator and analyzer' in order to build a sustainable business plan," they said.
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