The planned Health Information Exchange (HIE) Onboarding Program will support the initial costs of onboarding (connecting) priority Medicaid providers to a community-based HIE that provides meaningful HIE opportunities and that plays a vital role for Medicaid in that community.
Why it’s needed
Currently, there are many forms of health information exchange in Oregon. However, significant gaps in HIE coverage remain, and those gaps make it more difficult for critical Medicaid providers to provide efficient, patient-centered, coordinated care. Community-based HIEs can help meet critical Medicaid providers’ HIE needs through a wide range of HIE services that support referrals, coordination of care, and transitions of care.
Fundamental principles of the program
- Support meaningful (trusted, relevant, actionable, and timely) health information exchange that providers value and participate in actively
- Support state and Medicaid objectives
- Align with HITOC’s HIE strategic plan and vision
- Assess periodically to confirm priorities and adjust to changes in the environment
What the program will do
- Support HIE entities’ costs for onboarding priority Medicaid providers
- Support HIE entities who can support Medicaid objectives (e.g., open participation, capable of inter/intra-state exchange)
- Support a combination of provider types in a staged approach
- Support basic standards for HIE entities
- Leverage existing infrastructure
- Support a network of networks
What the program will not do
- Establish a state-run HIE
- Provide funding directly to providers, clinics, hospitals, or health systems
- Establish new HIEs
- Support HIEs who do not support Medicaid objectives
- Support the ongoing costs of HIE entities after onboarding is complete
- Support operational costs or purchase electronic health records technology
Phase I priority Medicaid providers
The program will support onboarding of critical Medicaid providers designated as priority. Phase I of the program will focus on promoting integrated care, and therefore the priority providers for that phase will be critical Medicaid behavioral health, oral health, and physical health providers. The program will also incentivize early onboarding of major trading partners to help create value for other priority providers, especially those who might otherwise face greater barriers to connecting.
Phase I Priority Providers
Community Mental Health Programs, Certified Community Behavioral Health Centers, behavioral health homes, Assertive Community Treatment teams, mobile crisis teams
Clinics contracted with Medicaid dental care oganizations serving coordinated care organizations' members and fee for service population
Medicaid providers who participate in: Patient-Centered Primary Care Homes, Federally Qualified Health Centers (FQHC) (incl. FQHCs using alternative payment models), Rural Health Centers, Comprehensive Primary Care Plus, tribal health, equity-focused clinics, corrections health
The roadmap for later phases includes long-term services and supports, social services, and other critical Medicaid providers as priorities.
The Program will be funded by 90 percent federal funds and 10 percent state funds under the Health Information Technology for Economic and Clinical Health (HITECH) Act. As of February 2016, HITECH funds may be used to support HIE onboarding of providers and hospitals eligible for federal electronic health record (EHR) incentive payments (eligible providers) and those Medicaid providers who are not eligible providers (including behavioral health, long term care, corrections, etc.). Onboarding must connect the new Medicaid provider, with or without an EHR, to an eligible provider and help that eligible provider meet meaningful use.
For more information, contact Kristin Bork at firstname.lastname@example.org.