Connecticut Medical Society Launches HIE When State Can’t Pull It Off

Posted on September 7, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The Connecticut State Medical Society had had enough. Its members had waited 10 years for the state of Connecticut to launch a functioning HIE, to no avail, so the Society decided to take matters into its own hands.

Now, the state’s physicians, healthcare facilities, and assorted other providers are sharing data via the medical society’s new HIE, CTHealthLink.  Participants who use the HIE not only share data but also have access to reports designed add value to physician consults and improve outcomes.

The CSMS project must have been daunting, but at least it had a model to use. Its approach is based on a provider-backed HIE in use in Kansas, the Kansas  Health Information Network (KHIN). KHIN brought the Kansas Hospital Association, the Wichita Health Information Exchange and greater Kansas City HIE eHealthAlign together.

If you read the HIE project overview, it becomes clear that CSMS wants to help members navigate MACRA requirements.  “The goal is to empower physicians as they transition to the new alternative payment models involving quality reporting, advancing care information, and improvement activities,” the CSMS notes on the CTHealthLink site.

Prior to the CTHealthLink rollout, CSMS leaders worried that clinicians would miss out on Medicare and Medicaid incentives provided for participating in an HIE, and be subject to penalties instead, according to Matthew Katz, Executive Vice President and chief executive officer of the physician group, who spoke to The CT Mirror.

Under MIPS, all physicians and many other clinicians can get incentives for participating in a HIE, an attractive prospect. However, the flipside of this is that eligible providers who don’t participate in MIPS by the end of 2017 would see a 4% cut in their Medicare reimbursement in 2019, obviously attractive prospect. Small wonder that the CSMS couldn’t wait longer.

The state’s clinicians have been quite patient to date. According to the Mirror, Connecticut’s first HIE effort was in 2007, when they attempted to create network specifically for Medicaid. Though the network was backed by a $5 million grant, it failed, as few physicians had adopted digital medical records at the time.

Between 2007 and 2016, the state followed up with two more efforts to connect state providers. Both efforts failed to create a functioning system, despite having $18 million in funding to back its efforts.

In contrast, CTHealthLink is steaming ahead. But there is a catch. At $50 to $120 per physician per month, joining the HIE can be pretty pricey, especially for large practices. For example. at $50 per physician per month, a medical practice of 1,200 physicians would pay approximately $720,000 per year, or as much as $1.7 million if the $120 monthly fee applied, noted Lisa Stump, chief information officer for Yale New Haven Health, who also spoke to the Mirror. This may very well inhibit the HIE’s growth.

Meanwhile, despite previous failures, the state of Connecticut hasn’t given up on creating its own HIE, this time with $14 million in federal and state funding. One of the key drivers is an effort to make Medicaid reporting simpler, which the state’s Department of Social Services is cheering on. The state’s HIE is scheduled to be functioning by the beginning of 2018. Maybe the fourth time will be the charm.