Thursday, October 11, 2012

Health Insurance and Information Exchanges Slow to Develop
It's just  one exchange after another.


October 11, 2012 -  Individual states are reluctant to set up and finance health insurance and information exchanges until results of the November election are know

·         A health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies. All exchanges must be fully certified and operational by January 1, 2014 under federal law

·         Health information exchange (HIE) is the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged.

The goal of these HIEs is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care and to give patients choice of health plans endorsed by government  HIE is also useful to public health authorities to assist in analyses of the health of the population.

So much for good intentions.  Now for the politics of health reform.  We have an election coming up in November, and it will decide the fate of Obama’s health law,  which depends heavily on the use of computer-generated data to work.   Governor Romney, who is now leading narrowly in the polls, has promised to repeal Obamacare.

Where does this political uncertainty over who will win the presidency leave HIEs?  It leaves their future in doubt, and it leaves the states in uncertainty as what to do about HIEs,  for these entities tend to be state-based and cost millions of dollars to implement, 

·         In the case of Health Insurance Exchanges, here is the state of play:   16 states are studying their options,  7 states have decided not to implement exchanges, 3 states are planning to implement,  16 states have established exchanges,  and in 8 states, there is no HIE activity, one way or another.

·         In the case of Health Information Exchanges,  300 have been established in multiple states, but even within states, the individual HIEs are dueling with one another to establish standards and to compete for HITECH funds.

This much is known.  Sixty nine percent of physicians are now using Electronic Health Records (EHRs),   many of these EHRs do not communicate with each other or with hospital systems.   For physicians,  health information exchanges lack  interoperability, lack infrastructure, and cost too much to set up and to maintain interfaces.  Hospitals and the government may help in the funding, but there many standardization question to be answered and many bureaucratic snarls to be disentangled.

Tweet:  Obamacare requires data for insurance and information exchanges but many states await election results before acting on these exchanges.


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