If HIEs Were a Netflix Series: Charting a Path to Renewal

If non-profit Health Information Exchanges (HIEs) were a Netflix series, they'd be critically acclaimed yet struggling to secure renewal for another season. Once supported heavily by federal 90/10 funding, akin to a blockbuster series with substantial studio backing, their financial landscape changed dramatically when those funds ended in 2021. Now, like any good drama, HIEs must navigate the suspenseful challenge of sustainable financing, with primary expenses centered around technology infrastructure and skilled personnel. And the latest plot twist? Heightened expectations from stakeholders, notably CMS’s recent "Make Health Care Great Again" announcement, without extra financial backing.

Each HIE, much like individual shows, has its unique storyline reflecting regional priorities and audience (stakeholder) interests. For example, the Indiana Health Information Exchange (IHIE) successfully "subscriptions its way" through seasons, largely relying on hospital fees and tailored analytics services. Maryland's Chesapeake Regional Information System for our Patients (CRISP) has diversified its cast of funders through state initiatives, payer contributions, and specialized services, akin to a popular ensemble cast keeping ratings steady.

Hospitals, essential yet reluctant viewers, often resist subscribing unless there's a gripping reason. For example, real-time EMS data delivery provides San Diego hospitals that irresistible plot hook they can't ignore. Unfortunately, national networks offer less compelling episodes, often characterized by unreliable match rates, making local HIE content much more binge-worthy. Other engaging plotlines hospitals might invest in include predictive analytics for readmission cliffhangers, sepsis and infection risk "spoiler alerts," and streamlined perioperative or discharge coordination narratives that keep them coming back episode after episode.

Health plans, the streaming service giants of healthcare, will only greenlight funding for storylines with clear ROI, like certified Healthcare Effectiveness Data and Information Set (HEDIS) data. Without impactful episodes directly tied to these measures, they may swipe left on funding. New must-see content, like medication adherence dramas, gaps-in-care suspense stories, and chronic disease predictive modeling series, could offer enticing hooks for investment.

Broadening the cast to include behavioral health and social care data, protected by rigorous privacy regulations like 42 CFR Part 2, introduces exciting new characters and story arcs previously unseen. Social determinants of health (SDoH) add deeper context and more nuanced plots, directly improving care coordination and outcomes that attract investment from both hospitals and health plans.

Specialized "spin-off series" can provide significant value. Correctional health alerts offer gripping storylines that keep hospitals and community providers from unnecessary and redundant episodes of emergency care. Special patient registries, such as opioid overdose or chronic disease management, generate valuable insights, producing fan-favorite moments that payers and providers eagerly await.

A recent survey from Civitas Networks for Health, formerly known as SHIEC, underscores the importance of diversified revenue sources. The study highlights that sustainable HIEs typically derive around 60% of their budget from subscribers, with the remainder supplemented by grants and contracts. This diversified approach is much like a hit show blending streaming revenue with merchandise and licensing deals to ensure long-term success.

To secure renewal season after season, HIEs must continuously innovate and produce compelling content. By clearly demonstrating measurable value through diverse and impactful services, including enhanced EMS plot twists, certified HEDIS cliffhangers, predictive analytics storylines, real-time clinical alerts, specialized registries, and advanced care coordination dramas, HIEs can attract essential funding and cement their role as must-watch players in advancing healthcare interoperability and patient care outcomes.