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HIE Onboarding Program

 

Program summary

 

The planned Health Information Exchange (HIE) Onboarding Program will support the initial costs of connecting (onboarding) priority Medicaid providers to a community-based HIE that provides meaningful HIE opportunities and that plays a vital role for Medicaid in that community.

 

Subscribe to OHIT - HIE Onboarding Program

 

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.

 

What the program will do

 
  • Support Community-Based HIEs
    • At a minimum, provide core HIE services: community health record plus referrals and/or results delivery
    • Open to priority Medicaid providers regardless of ownership affiliation or EHR used
  • Support HIE-side costs for onboarding priority Medicaid providers
  • Require HIEs to make a meaningful financial contribution to provider-side costs for providers that face barriers (in-kind or otherwise)
  • Support a variety of Medicaid provider types (phased)
  • Leverage existing infrastructure
  • Support a network of networks
 

What the program will not do

 
  • Support entities that are not Community-Based HIEs
    • Will not support HIEs that do not provide core services
    • Will not support HIEs that require a particular ownership affiliation to qualify for participation
    • Will not support EHR-based solutions that require providers to use a single EHR vendor in order to participate in exchange
  • Establish a state-run HIE
  • Provide funding directly to providers, clinics, hospitals, or health systems
  • Establish new HIEs
  • Support the ongoing costs of HIEs after onboarding is complete, operational costs, or purchase EHRs
 

Phase I priority Medicaid providers

 

The program will support onboarding of critical Medicaid providers designated as "priority". Phase 1 of the Program will focus on supporting integrated care: behavioral health, oral health, and physical health (see table below). Phase 1 will also include Major Trading Partners. Onboarding Major Trading Partners early will create the value proposition for other Priority Medicaid Providers.

 

Phase I Priority Providers

 

Community Mental Health Programs, Certified Community Behavioral Health Centers, behavioral health homes, Assertive Community Treatment teams, mobile crisis teams

Clinics and providers serving Medicaid members, including those contracted with managed care entities and those serving fee for service (i.e., open card) populations

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

​Major trading partners (hospitals, health systems, and other large organizations that priority Medicaid providers need to communicate with) that create value for priority Medicaid providers

 

The roadmap for later phases includes long-term services and supports, social services, and other critical Medicaid providers as priorities.

 

Funding

 

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.

 

Stakeholder and Tribal Engagement

 

The program was developed after extensive engagement with a wide variety of internal and external stakeholders. This included OHA stakeholder groups, like the Health Information Technology (HIT) Oversight Council, the HIT Advisory Group (with Medicaid Coordinated Care Organization representatives), and the HIT/HIE Community and Organizational Panel. OHA also formed a short-term advisory group composed of stakeholders across the state. OHA met individually with stakeholders from corrections, long-term services and supports, behavioral health, social services, frontier providers, supported housing, and others. OHA interviewed eight states with similar programs about best practices. Finally, OHA received helpful information through a request for information open to organizations operating an HIE in Oregon. OHA will continue to engage with stakeholders throughout the program.

 

For more information, contact Kristin Bork at kristin.m.bork@state.or.us.

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