The merger comes at a likely inflection point in the more than two-decade history of health information exchanges, whose fortunes received a financial boost in 2009 with passage of the American Recovery and Reinvestment Act. The stimulus law provided $548 million in federal grantsto states, territories and the District of Columbia to set up and sustain HIEs. It's still unclear whether many HIEs will survive without federal or state subsidies, however.
In a 2013 survey of almost 200 of the 315 HIEs nationally, 51 organizations “indicated that they received sufficient revenue from participating entities to cover operating expenses, while 51 have not,” according to the eHealth Initiative, a Washington, D.C.-based not-for-profit organization that promotes the use of health information technology.
Also, 49 responding organizations derive 50% or more of their funding from public sources and 17 of those expect public funding to remain “their most substantial funding source in the future,” the report said.
“Despite continued reliance on public funding by some, organizations realize the precariousness of this revenue source and are working to achieve full sustainability by offering valuable services for a fee,” it said.
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