HIE Financial Sustainability
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Financial sustainability is the issue that is still perplexing to HIEs across the country. Many stakeholders at the state level are looking for the magical answer to sustainability. Our experience and research indicates sustainability is more about the process (the how) than about the answer (the what). Success usually comes from doing the hard work of building consensus between stakeholders and finding the sustainability model that works for each individual HIE.
Several HIEs are moving towards sustainability but each one has adopted a fairly unique model. At this time, there is no commonly accepted formula for achieving sustainability. After working with six different states and territories on sustainability, reviewing myriad literature regarding HIE sustainability, and talking with numerous experts in the field, our conclusion suggest it is a matter of following a proven process.
Unfortunately, many HIE efforts have postponed the sustainability question to very late in the process. Many HIEs have focused their initial efforts on technology, privacy and security, and governance. Sustainability is a difficult issue and has been viewed as a lower priority in the development of the HIE. Unfortunately, sustainability is the issue that is the most frequent cause of failure. Many states have recently received approval for their strategic and operational plans. Now is the time to address the sustainability issue.
Of the current models in place, there are different ways of raising revenue and achieving sustainability. However, each sustainability model has pros and cons. Therefore, we believe that use a robust process to identify the right mix of funding sources and gain stakeholder support will help an HIE find the model that works for it. Only by following the process can HIEs find the mix that satisfies the unique conditions surrounding each HIE.
The process we recommend uses eight (8) integrated Phases to find the sustainability model that satisfies the wants and needs of any particular HIE. These Phases include:
- Phase 1 – Stakeholder Engagement
- Phase 2 – Research and Analysis
- Phase 3 – Principles and Stakeholder Value Propositions
- Phase 4 – Capital and Operating Strategies
- Phase 5 – Risk Mitigation
- Phase 6 – Financial Modeling and Scenario Development
- Phase 7 – Stakeholder Testing and Modifications
- Phase 8 – Adoption and Implementation
Each Phase is closely integrated with the other Phases and frequently overlap. For ease of understanding, each Phase will be described separately. Please contact us directly to discuss how we can help you implement a financially sustainable HIE plan for your unique challenges.
Our Experience
Hielix is well qualified to assist your HIE design and implement a business and financial sustainability strategy. We have extensive experience in multiple states and territories as well as a staff of leading financial experts with broad experience in Health Information Exchange (HIE) and Medicaid. Listed below are some of our recent and current projects related to financial sustainability.
- Guam – Consulting partner/advisor to create the Territory HIE Strategic and Operational Plans for Guam
- Guam – Consulting partner/advisor for architecting, designing and implementing the Territory of Guam Health Information Exchange
- Guam - Consulting partner/advisor for the HIE Business and Financial Sustainability Plan for the Territory of Guam
- Iowa – Consulting partner/advisor for the HIE Business and Financial Sustainability Plan for the State of Iowa
- Mississippi – Consulting partner/advisor to create Statewide HIE Strategic and Operational Plans for the State of Mississippi
- Mississippi – Consulting partner/advisor to the State of Mississippi State Medicaid HIT Plan (SMHP)
- Mississippi - Consulting partner/advisor for the HIE Business and Financial Sustainability Plan for the State of Mississippi
- Nebraska – Consulting partner/advisor to the State of Nebraska State Medicaid HIT Plan (SMHP)
- Nevada - Consulting partner/advisor to the State of Nevada State Medicaid HIT Plan (SMHP)
- North Dakota – Consulting partner/advisor to create Statewide HIE Strategic and Operational Plans
- North Dakota – Consulting partner/advisor for the HIE Business and Financial Sustainability Plan for the State of North Dakota
- Puerto Rico - Consulting partner/advisor for the HIE Business and Financial Sustainability Plan for the Commonwealth of Puerto Rico
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