Health Information Organization Sustainability

Improving Patient Outcomes and Driving Revenue in a New Era of Valued-Based Care

HITECH funding has expired.
What’s next to help HIOs progress? 

Health information organizations (HIOs) have become a critical part of the digital health data ecosystem that developed with the establishment of the Health Information Technology for Clinical and Economic Health (HITECH) Act of 2009. HIOs are often charged with securing federal funding necessary to implement and maintain the local, statewide, or regional health information exchanges (HIEs), which allow healthcare providers to access patient information quickly and securely. Given the rising cost of healthcare, increasingly complex provider and payer systems, and the challenges associated with technology adoption in any large-scale industry, HIOs have come to play a vital role in facilitating timely and accurate health data exchange for improved care coordination and enhanced interoperability.

However, the expiration of the HITECH Act–and the federal funds it provided to HIOs–will require a new approach to secure long-term sustainability. HIOs must develop a strategy to increase revenue and reduce costs as federal funding becomes less generous and more difficult to obtain. Audacious Inquiry is a national leader in partnering with HIOs to develop sustainable revenue models that enhance HIO capabilities and further engagement with health plans, health systems and providers.

The U.S. healthcare system has increasingly recognized the role of HIOs and interoperable health data in driving down the total cost of care by reducing unnecessary emergency department utilization, increasing patient outcomes and quality, and driving patient and provider engagement. As healthcare steadily moves towards value-based care models, payers, providers, and health systems will increasingly need access to high-quality HIO services to perform well in risk and value-based environments.

Audacious Inquiry has partnered with HIOs across more than a dozen states for over a decade, bringing robust experience in establishing successful and sustainable revenue models. But these revenue models are not merely financial tools. Critically, market-driven participation of key stakeholders drives deeper engagement, more robust HIO services, and—ultimately—improved outcomes.

In this whitepaper, we offer an overview of the current state of HIO funding, map out a sustainable path forward for HIOs a the intersection of value-based care, and provide successful revenue model examples.

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