Governors Initiatives to Encourage Adoption of Health Technology

Governors’ Initiatives to Encourage Adoption of Health Technology Information Exchange John Thomasian Director, National Governors Association Center for Best Practices 1 6/11/2021

Why Governors Care About HIT l l l The health care system is broken $1. 7 billion industry. We spend twice as much as other industrialized countries and our results are half as much Medicaid now consumes 23 % of state budgets, surpassing our investments in K-12 The private sector is shifting health care coverage to the public sector when they can Everyone else left in middle— 45 million Americans uninsured

System is Broken

What is the fix? Un-fragment a fragmented system l HIE is the backbone for overall health care reform. l HIE can tie records together, reduce unnecessary and redundant procedures, help improve quality, build basis for P 4 P, and reduce administrative costs l

Governors’ Goals for Health Care Reform Deploy HIE and EMR to improve services and productivity l Improve quality of care, including disease prevention and management l Allow innovative financing strategies and rule changes to expand coverage l Empower consumer choice through price transparency, quality reporting, and financial incentives l

What are the Governors’ Levers? The power to convene and bring disparate stakeholders to the table through task forces and other structures l Bully pulpit—sell it to the public and business l The regulatory lever l Incentives—tax codes, grants, reimbursement processes l State also is major market participant l

Who is doing What? l l At least 30 states are moving forward in some manner to facilitate adoption of HIE Most are setting up tasks forces and commissions to examine the issue and recommend next steps A few—like Arizona and Florida—are establishing roadmaps for implementation, creating organizations to set standards, develop business practices, and forge linkages between networks All are convening key groups of experts, providers, insurers, consumers, and other stakeholders

The Challenges Creating partnerships with and getting input from stakeholders l Agreeing on architecture l Creating standards and common exchange elements l Establishing governance l Solving security and privacy issues l Developing a business model and incentives for adoption l

Big Questions Remain l What business model or models make the most sense? – Big statewide private or public network? – Several big competing networks operating in parallel, sharing data? – Broker that strings together disparate, small networks Financing—transaction fees, membership fees, or both? l Privacy—can we live with non-uniform, state-by-state system? l