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Oregon Health Authority

Health Information Exchange (HIE) Onboarding Program

Program Overview

The Health Information Exchange (HIE) Onboarding Program launched in January 2019 and concluded September 30, 2021 with the sunset of federal funding. The Program leveraged significant federal funding to increase Medicaid providers' capability to exchange health information by supporting the initial costs of connecting (onboarding) priority Medicaid providers to a community-based HIE. Provider participation in the program was voluntary and required CCO involvement. By the end of the Program, over $2.4 million had been spent successfully connecting 72 unique entities (109 individual sites), including: 11 behavioral health practices, four oral health clinics, 50 critical physical health entities, and seven major trading partners (hospital/health system/major referral center). Reliance eHealth Collaborative was selected as the HIE vendor through an RFP process.

The HIE Onboarding Closure Summary can be found here

Details

Reliance onboarded priority Medicaid physical, behavioral, and oral health providers, according to a work plan developed in consultation with Medicaid partners. CCOs were involved in determining whether providers in their region participate in the Program and provide input on annual work plan development. To participate in the Program, CCOs were required to have a data, funding, or governance relationship with Reliance.

Providers who participated received financial support from the HIE, as well as financial support from OHA to offset or partially offset their administrative onboarding costs. OHA paid Reliance to support the initial costs of new connections to the HIE.

Specific Providers Onboarded

The Program focused on supporting integrated care: behavioral health, oral health, and physical health. This also includes Major Trading Partners such as hospitals, labs, etc.


Phase 1 Priority Medicaid Providers

Behavioral health: Community Mental Health Programs, Certified Community Behavioral Health Centers, Behavioral Health Homes, Assertive Community Treatment teams, mobile crisis teams, and other state-licensed behavioral health organizations

Oral health: Clinics and providers serving Medicaid members, including those contracted with managed care entities and those serving fee for service (i.e., open card) populations

Critical physical health: Medicaid providers who participate in: Patient-Centered Primary Care Homes, Federally Qualified Health Centers (FQHC), Rural Health Centers, Comprehensive Primary Care Plus, tribal health, equity-focused/culturally specific clinics, and county corrections health

Major Trading Partners Major Trading Partners include hospitals, health systems, multi-specialty clinics, laboratories and radiology, especially those that affect the value of HIE for smaller and rural/frontier providers

Timeline

The Program launched in January 2019 and concluded September 30, 2021.

Funding and Funding Requirements

The Program was funded by the Centers for Medicare & Medicaid Services (CMS) with 90 percent federal funds under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which is available through 2021. State funds make up the remaining 10 percent, with approved funding for the 2017-19 and 2019-21 biennia.

As of February 2016, HITECH funds could be used to support HIE onboarding (connecting) of providers and hospitals eligible for federal electronic health record (EHR) incentive payments (“eligible providers") and those Medicaid providers who were not eligible providers (including behavioral health, long term care, corrections, etc.).

Onboarding connected the new Medicaid provider to an eligible provider and help that eligible provider meet federal “meaningful use" requirements. The new Medicaid provider being onboarded did not need an EHR to participate; for example, connections through Reliance's web portal to the Community Health Record were also available.

Stakeholder Input

The Program was developed after extensive engagement with a variety of stakeholders, including OHA stakeholder groups, like the Health Information Technology (HIT) Oversight Council, the HIT Advisory Group (with Medicaid Coordinated Care Organization representatives), and the HIT/HIE Community and Organizational Panel. OHA also formed a short-term advisory group of stakeholders across the state to inform program development. OHA met individually with stakeholders from corrections, long-term services and supports, behavioral health, social services, frontier providers, supported housing, and others. OHA interviewed eight states with similar programs about best practices. Finally, OHA received helpful input through a request for information open to organizations operating an HIE in Oregon.

The HIE Onboarding Closure Summary can be found here