A case study in HIE consolidation
In 2015, Health Current counted 75 payers, providers and other organizations as part of its health information exchange. Today, the Arizona-based not-for-profit includes more than 850 healthcare groups—and counting—as part of its network.
Health Current’s more than tenfold growth over the past six years can be credited to a switch to a new technology platform that allowed it to scale its participant base and send real-time updates to providers, said CEO Melissa Kotrys, who also chairs the Strategic Health Information Exchange Collaborative, the national association of HIEs.
In 2015, Health Current also waived fees for any nonhospital and payer participants, which Kotrys said helped drive participation among federally qualified health centers, behavioral health providers, long-term care facilities and more. A strong partnership with the state’s Medicaid agency and thoughtful representation on its board of directors has also helped drive user trust—and transactions.
Health Current’s 27-person board of directors includes three representatives from Medicaid and other state agencies, an equal number of hospital and health plan representatives and 10 individuals from its different participant segments, like laboratories or ambulatory service providers. This allows Health Current’s users to access records for an average of 91,000 patients per month.
“By having more and more of the healthcare community participating, it makes it an all-in scenario, where everybody gets the benefit of everyone else participating,” Kotrys said.
The state-based exchange is in the process of merging with the Colorado Regional Health Information Organization, a regional HIE based in Denver.
The effort mimics recent activity in the HIE industry, where the prospect of saving on technology costs, creating a larger participant pool and responding to new regulations has caused a growing number of HIEs to consolidate.
“There certainly is a trend in the industry now where HIEs are merging, consolidating, regionalizing,” Kotrys said. “You might see some that maybe don’t seem like they’re there, but it’s not that they shut their doors because of a bad business model. It’s because we’re consolidating and merging as the industry evolves.”
At the start of 2020, the Indiana Health Information Exchange merged with two other state exchanges to create a single data-sharing system across Indiana and parts of Michigan. CRISP now coordinates information exchange across Washington, D.C., Maryland, West Virginia and parts of Connecticut. In January, the Nebraska Health Information Initiative announced it was rebranding to CyncHealth, to reflect its work connecting participants and technologies across Nebraska and Iowa.
As regional exchanges seek to balance their books after a rocky 2020, the trend toward consolidation has accelerated, said CyncHealth CEO Jamie Bland. These regional exchanges are thinking of a future beyond the mere transfer of patient data and looking to provide services around value-based care relationships, population health and more.
“It’s pretty much the same cost for a million or 10 million in population,” Bland said. “So I think there’s some consideration of what can states partner on as far as infrastructure goes. And if there’s going to be true infrastructure building from the health data perspective, what is the role of information exchange in that? There are HIEs, prescription drug monitoring programs connected to pharmacies, there are multiple infrastructures that could be consolidated, and economies of scale could be realized.”