Two of California's largest insurers are trying to build one of the country's most comprehensive health information exchanges, but they face reluctance from providers hesitant to share their data.
Anthem and Blue Shield of California—the second- and third-largest insurers in the state, respectively, after Kaiser Permanente—teamed up in 2014 to establish Cal Index. Their goal is to create a complete, longitudinal health record for every California resident.
But they still need the buy-in from state health systems, which must be willing to share their data and pay a fee to access data from others. Cal Index currently has payer records on 9 million people, covering three years of claims data. The data do not include prices.
Only one health system—San Francisco-based Dignity Health—has agreed to join the exchange and will go live at the end of this month. Cal Index is in discussions with a few other systems and hopes they will soon sign contracts as well, said Cal Index CEO David Watson. Kaiser, the state's largest health plan, is not in that initial group.
Notably, Kaiser was one of the many providers and electronic health record developers that pledged last week to make it easier for patients and healthcare organizations to access and share data. It's part of an overall push by the government to obtain the elusive interoperability of EHRs. Kaiser said in a statement that it participates in all regional, state and national HIEs that are using HHS' national standards.
“Cal Index could join the nationwide eHealth Exchange, sign the federal data use and reciprocal support agreement like Kaiser Permanente and other state exchanges have done,” the Oakland, Calif.-based system said.
Watson acknowledges the job ahead. “We've been doing outreach to payers and providers since midyear last year,” he said. “But our challenge is that we're not closing on providers as quickly as we wanted to.”