Webinar: No one financial 'silver bullet' for HIE funding

There is no one financial silver bullet to funding a health information exchange (HIE), according to Keith Hepp, vice president of nonprofit HIE HealthBridge who spoke during a Webinar broadcast Dec. 22, 2009, sponsored by California eHealth Collaborate (CAeHC).

CAeHC’s weekly Webinars provide presentations from national subject matter experts speaking on a variety of topics related to the development and operation of HIE. According to CAeHC, HealthBridge is one of the largest and most financially successful HIEs nationwide.

Founded in 1997, HealthBridge serves 28 hospitals throughout Cincinnati and its surrounding areas. Through its clinical messaging system, the HIE delivers more than three million clinical results (laboratory, radiology, transcription and ADT) to more than 5,200 physicians every month, according to Hepp.

Hepp said that the Cincinnati-based HealthBridge began using a subscription model-based enterprise approach and was built off loans. Since HealthBridge began in a time when grants were not readily available, Hepp said that HealthBridge formed a disciplined approach to develop methodologies to show financial returns in the HIE’s early stages.

The loan notes will be paid off by 2012, according to Hepp.

HealthBridge is internally funded with 97 percent of revenues from fees with a 5-8 percent annual return for the last five years, according to Hepp. Its business model shows that 65 percent of its revenue comes from health systems, 15 percent from laboratories, 3 percent from grants, 12 percent from external HIE services and 5 percent from transcription and billing revenues.

Although Hepp acknowledged no one single financial silver bullet for HIEs, he highlighted a few key financial lessons that HealthBridge experienced since its formation:
  • Align costs with benefits received;
  • Starting with a messaging metaphor is highly recommended to get various content providers participating in a HIE;
  • Treat American Recovery and Reinvestment Act of 2009 (ARRA) funding the same as capital;
  • Use ARRA money to buy-down future costs;
  • Look for cheaper and easy solutions (ex: CCHIE and HealthLINC connected using HL7); and
  • State HIE’s are fine but local governance builds buy-in.

CAeHC weekly Webinars archives and information can be accessed through the organization's website.

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