As a nation, we are transforming health care delivery into a system that is patient-centered and value-based. Critical to this transformation is timely interoperable Health Information Exchange (HIE) among a variety of health care stakeholders (clinicians, laboratories, hospital, pharmacy, health plans, payers and patients). The Centers for Medicare & Medicaid Services (CMS) already has a large role in encouraging HIE through existing Medicare and Medicaid programs and initiatives, as well as new programs authorized under the Patient Protection and Affordable Care Act (PPACA). The resources and focal areas found on this page reinforce the unique role that Medicaid plays in advancing HIE. CMS expects to increasingly engage states on how to best align their Medicaid programs to support HIE.
- Federal Financial Participation for HIT and HIE
- Fee-for-Service HIE Policy
- Managed Care Organization HIE Policy
- Section 1115 Demonstration HIE Policy
Examples of states aligning Health Policy and Health Information Exchange strategies:
- Approved Health Home State Plan Amendments
- Approved 1115 Demonstrations accelerating HIE & Medicaid Transformation
- Oregon Health Plan 2 (PDF 3.37 MB)
Medicaid Program Alignment with State Systems to Advance HIT, HIE and Interoperability
CMS, in coordination with the Office of the National Coordinator, has created a series of toolkits and resources for Medicaid (Health Home State Plan Amendment, 1115 Demonstrations, and programs that advance Home and Community Based Services) that are focused on health information exchange, health IT, and interoperability.
States can use these toolkits as they are designing their Medicaid programs. Use of these tool kits will help states:
- Ensure they have the health IT capacity and infrastructure to accomplish their Medicaid program goals.
- Identify and adopt a common set of health IT standards (where federally recognized standards exist) among states to promote information sharing (interoperability).
For questions, technical assistance or suggestions, please contact ONC at Onc.Request@hhs.gov.