Today, one of the challenges NEHEN is facing, says Giancola, is restructuring the funding formula based on the requirements of ARRA and HITECH. "Payers were at the table and interested in participating because it saved them a great deal of money," he says.
Now that administrative data is a solved problem—for the most part—and payers are only involved in two of the nine different meaningful use recommendations for health information exchange, payers don't want to fund the exchange at the same rate, he says. "They don't think that they should bear as much of the burden any more and provider organizations have to pick up the slack."
There will need to be more of a fundamental shift in the financing model, says Giancola, explaining that it's going from administrative to doing more clinical transactions. "The providers will have to take on more of the financial burden for next few years," he says.
Therein lies the challenge—most providers are hard pressed to come up with the extra capital to add the technologies required by the HITECH Act. And while the incentive payments are nice and a great benefit, they don't cover all of the costs associated with installing and meaningfully using EHRs. Then again, providers can't afford being hit with penalties in 2015 and beyond, either. So if you have any solutions on how to make health information exchange financially viable, please pass it on.