New MarketScape Report from IDC Health Insights Evaluates Evolution of Health Information Exchange Platform Solutions

FRAMINGHAM, Mass.--(BUSINESS WIRE)--

A new IDC MarketScape report from IDC Health Insights highlights the rapid evolution of the health information exchange (HIE) market. The comprehensive study, IDC MarketScape: U.S. Health Information Exchange Platform Solutions 2012 Vendor Assessment (Doc #HI235816), provides an evaluation of 16 vendors that offer a platform solution for Health Information Exchange. IDC Health Insights defines a platform as having development tools, published APIs, education of technical staff, a broad ecosystem of partners, and professional services. Vendors evaluated for this report include: AT&T, AxSys Technology, Caradigm, Carefx, Certify Data Systems, Covisint, dbMotion, IBM, Infor, InterSystems Corp., Medicity, OptumInsight, Oracle, Orion Health, RelayHealth, and Verizon.

The health information exchange market continues to evolve with the focus shifting from connecting the ecosystem to exchange data and qualify for meaningful use incentives, to turning data into "actionable information" that enables emerging accountable care or collaborative care initiatives. This shift has lead to additional market consolidation among HIE vendors. Since the IDC Health Insights report Vendor Assessment: Industry Short List for Health Information Exchange Technologies was published two years ago (March 2010, Doc #HI222529), seven HIE vendors have been acquired or merged and new, nontraditional players have entered the market including payers and telecommunication companies.

"The IT requirements for health information organizations and evolving care delivery and reimbursement models are too extensive for any one vendor to satisfy," said Lynne Dunbrack, program director, Connected Health IT Strategies at IDC Health Insights. "To address the business and technical requirements of accountable care, in addition to providing core HIE technologies, vendors are responding by developing, partnering, or acquiring analytics, collaborative care, and patient engagement technologies."

Platform-as-a-service will increasingly play an important role in delivering HIE capabilities as vendors look to create an ecosystem of strategic partnerships. Platforms will evolve over time to meet the needs of customers and partners in the ecosystem, often through self development. In contrast, packaged solutions are designed to meet a very specific set of requirements. The IDC MarketScape vendor assessments for HIE technology are not all inclusive as there are other vendors that provide either a packaged or platform solution for HIE. Additional HIE vendors are covered in IDC MarketScape: U.S. Health Information Exchange Packaged Solutions 2012 Vendor Assessment (Doc #HI235830), which covers ten vendors that offer a packaged solution for HIE.

IDC MarketScape criteria selection, weightings, and vendor scores represent well-researched IDC judgment about the market and specific vendors. IDC analysts tailor the range of standard characteristics by which vendors are measured through structured discussions, surveys, and interviews with market leaders, participants and end users. Market weightings are based on user interviews, buyer surveys and the input of a review board of IDC experts in each market. IDC analysts base individual vendor scores, and ultimately vendor positions within the IDC MarketScape, on detailed surveys and interviews with the vendors, publicly available information and end-user experiences in an effort to provide an accurate and consistent assessment of each vendor's characteristics, behavior and capability.

For additional information about this study, or to arrange a one-on-one briefing with Lynne please contact Julie Crotty at 978-877-0053 or Julie@attunecommunications.com. Reports are available to qualified members of the media. For information on purchasing reports, contact insights@idc.com; reporters should email Julie@attunecommunications.com.

About IDC MarketScape

IDC MarketScape vendor analysis model is designed to provide an overview of the competitive fitness of ICT (information and communications technology) suppliers in a given market. The research methodology utilizes a rigorous scoring methodology based on both qualitative and quantitative criteria that results in a single graphical illustration of each vendor’s position within a given market. IDC MarketScape provides a clear framework in which the product and service offerings, capabilities and strategies, and current and future market success factors of IT and telecommunications vendors can be meaningfully compared. The framework also provides technology buyers with a 360-degree assessment of the strengths and weaknesses of current and prospective vendors.

About IDC Health Insights

IDC Health Insights assists health businesses and IT leaders, as well as the suppliers who serve them, in making more effective technology decisions by providing accurate, timely, and insightful fact-based research and consulting services. Staffed by senior analysts with decades of industry experience, our global research analyzes and advises on business and technology issues facing the payer, provider and life sciences industries. International Data Corporation (IDC) is the premier global provider of market intelligence, advisory services, and events for the information technology market. IDC is a subsidiary of IDG, the world’s leading technology, media, research, and events company. For more information, please visit www.idc-hi.com, email info@idc-hi.com, or call 508-935-4445. Visit the IDC Health Insights Community at http://idc-insights-community.com/health

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Critics of Health Care Law Prepare to Battle Over Insurance Exchange Subsidies

Starting in 2014, the law requires most Americans to have health insurance. It also offers subsidies to help people pay for insurance bought through markets known as insurance exchanges.

At issue is whether the subsidies will be available in exchanges set up and run by the federal government in states that fail or refuse to establish their own exchanges.

Critics say the law allows subsidies only for people who obtain coverage through state-run exchanges. The White House says the law can be read to allow subsidies for people who get coverage in federal exchanges as well.

The law says that “each state shall” establish an exchange. But Washington could be running the exchanges in one-third to half of states, where local officials have been moving slowly or openly resisting the idea.

The dispute has huge practical implications. The Congressional Budget Office predicts that 23 million uninsured people will gain coverage through exchanges and that all but five million of them will qualify for subsidies, averaging more than $6,000 a year per person. Subsidies, in the form of tax credits, will be available to people with incomes from the poverty level up to four times that amount ($23,050 to $92,200 for a family of four).

Some supporters of the law say Congress may have made a mistake in drafting this section. But, they add, the intent of Congress is clear: subsidies should be available in federal as well as state exchanges.

The law says that subsidies will be provided to residents of a state to help defray the cost of health plans offered “through an exchange established by the state.”

A rule issued by the Obama administration allows tax credits for insurance bought in either a state or a federal exchange.

Political brawling over health care will continue this week on Capitol Hill. The House plans to vote on a Republican measure to repeal the 2010 health care law, Mr. Obama’s most significant legislative achievement. Democrats, who control the Senate, say repeal efforts have no chance of success there.

Representative Phil Roe, Republican of Tennessee, said the rule on premium subsidies “contradicts the explicit statutory language” of the Patient Protection and Affordable Care Act. Mr. Roe and another Tennessee Republican, Scott DesJarlais, have introduced a bill to nullify the rule, issued by the Internal Revenue Service.

Douglas H. Shulman, the I.R.S. commissioner, defended the rule as consistent with the intent of Congress. “The statute,” he said, “includes language that indicates that individuals are eligible for tax credits whether they are enrolled through a state-based exchange or a federally facilitated exchange.”

However, Senator Orrin G. Hatch of Utah, the senior Republican on the Senate Finance Committee, said the Obama administration was usurping the role of Congress and rewriting the law to provide tax credits through federal exchanges.

White House officials have repeatedly underestimated opposition to the health care law. They predicted that public support for the law would grow as people learned more about it. They minimized lawsuits challenging the constitutionality of the requirement for most Americans to carry health insurance. They predicted that states would embrace the opportunity to insure more of their residents by expanding Medicaid and creating insurance exchanges, but a number of states have balked.

James F. Blumstein, a professor of constitutional and health law at Vanderbilt University, said the dispute over subsidies involved a serious legal issue.

“The language of the statute is explicit,” Mr. Blumstein said. “Subsidies accrue to people who obtain coverage through state-run exchanges. The I.R.S. tries to get around that by providing subsidies for all insurance exchanges. That interpretation will almost certainly be challenged by someone.”

The most likely challenger, Mr. Blumstein said, is an employer penalized because one or more of its employees receive subsidies through a federal exchange. Employers may be subject to financial penalties if they offer no coverage or inadequate coverage and at least one of their full-time employees receives subsidies.

Michael F. Cannon, director of health policy studies at the libertarian Cato Institute, said the link between subsidies and penalties was a crucial part of the law.

“Those tax credits trigger the penalties against employers,” Mr. Cannon said. If workers cannot receive subsidies in states with a federal exchange, their employers cannot be penalized, he said. That, in turn, would hobble federal efforts to get employers to offer coverage in those states, Mr. Cannon said.

Prof. Timothy S. Jost, an expert on health law at Washington and Lee University, said Congress had made “a drafting error” that should be obvious to anyone who understands the new health care law.

“There is no coherent policy reason why Congress would have refused premium tax credits to the citizens of states that end up with a federal exchange,” said Mr. Jost, who supports the law.

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Catholic Health Initiatives Selects Orion Health as Health Information Exchange Technology Partner in its Enterprise ...

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Keystone Health Information Exchange Expands to Improve Care for Older Adults

Tue, Jun 5, 2012, 8:54 AM EDT - U.S. Markets open in 36 mins.

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Building a better health insurance exchange

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A prototype for Minnesota’s health insurance exchange.It’s no exaggeration to describe the health insurance exchanges as the health reform law’s backbone: For the 32 million Americans expected to gain health insurance, these state-based, marketplaces will likely be their first point of contact with the Affordable Care Act.

At their best, the exchanges could be an Expedia for health insurance, where consumers and small businesses easily compare and purchase insurance coverage. At their worst, exchanges could be like the Web sites we often associate with government services: Clunky and difficult to navigate. Ever visited anything on a Senate.gov domain?

For health reform’s coverage expansion to be successful, the White House needs the health insurance exchanges to look a lot more like the former: It needs 50 states with health insurance Expedias. And, in final standards for the exchanges published today, that’s pretty much the approach it encourages.

The White House does give states some flexibility in setting standards for their marketplaces. They get to decide who runs the new market and which insurance companies get to participate. They can outsource some functions that they don’t have capabilities for to the federal government.

At the end of the day though, it’s the White House that will determine if a state’s health insurance exchange is up to snuff. The new marketplaces will launch on Jan. 1, 2014. But a year prior, in 2013, Health and Human Services will certify which exchanges are - and aren’t - able to deliver the customer experience that the White House wants to see. That includes things like allowing consumers to easily compare plans and having an enrollment mechanism for both private insurance and Medicaid. States will have to summarize these developments next year in what the administration has now dubbed an “Exchange blueprint” before getting the go-ahead.

If a state hasn’t made significant progress towards those benchmarks by this time next year, the federal government will come in and do the job for it. Republican governors aren’t exactly thrilled with the prospect. Health insurance has traditionally been a state-regulated market, and the federal government's involvement does not seem like a positive prospect for some.

“The regulations issued today by the Department of Health and Human Services extend the federal government’s reach into the states and will cost the states millions of dollars annually to operate,” Republican Governors Association president Bob McDonnell, Virginia’s governor, said in a statement.

But, for the Obama administration, there’s a strong interest in ensuring that the health reform law looks a lot like what the law envisions: These exchanges are the main tool for expanding insurance to millions of Americans. So in walking a tightrope between stringent standards and state flexibility, the administration has leaned slightly towards the former.

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Blog Contributors

Ezra Klein is the editor of Wonkblog and a columnist at the Washington Post, as well as a contributor to MSNBC and Bloomberg. His work focuses on domestic and economic policymaking, as well as the political system that’s constantly screwing it up. He really likes graphs, and is on Twitter, Google+ and Facebook. E-mail him here.

Suzy Khimm covers the budget, economic policy, and financial regulatory reform. Before coming to Washington, she was based in Brazil and Southeast Asia, where she wrote for the Economist, Slate, and the Wall Street Journal Asia. Follow her on Twitter here, and email her here.

Sarah Kliff covers health policy, focusing on Medicare, Medicaid and the health reform law. She tries to fit in some reproductive health and education policy coverage, too, alongside an occasional hockey reference. Her work has appeared in Newsweek, Politico, and the BBC. She is on Twitter and Facebook.

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Inland Empire HIE Selects Orion Health For Community-Wide Health Information Exchange

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The nationwide average for gasoline prices eased Tuesday, marking the first decline after 27 straight days of increases, …

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Highmark Selects Verizon to Help Develop First Statewide Health Information Exchange to Improve Patient Care Through ...

NEW YORK and PITTSBURGH, Feb. 21, 2012 /PRNewswire/ -- Patients accessing health care services across Pennsylvania will soon benefit from fewer duplicative diagnostic tests, faster retrieval of clinical information, stronger safety measures and better coordination of care – all via a new IT platform that enables the sharing of patient information across multiple health care systems.

Highmark Inc. on Tuesday (Feb. 21) announced an agreement under which Verizon Enterprise Solutions will deploy and manage the technology infrastructure for Highmark's new health information exchange that will soon link health care organizations across western Pennsylvania that serve millions of people.  Highmark also plans to extend its HIE across the state over the next two years.  

The first health care organization to join the Highmark project is West Penn Allegheny Health System consisting of Allegheny General Hospital, Allegheny Valley Hospital, Canonsburg General Hospital, Forbes Regional Hospital and Western Pennsylvania Hospital.  Other health care organizations intending to participate in the Highmark HIE are: Butler Health System; Jefferson Regional Medical Center; MedExpress Urgent Care; Vantage Health Network (Lake Erie College of Osteopathic Medicine, Meadville Medical Center, Millcreek Community Hospital, Saint Vincent Hospital); and The Washington Hospital.  Highmark is also in discussions with other health care organizations across Pennsylvania and West Virginia.

"We welcome all hospitals, physicians and health insurers to become part of our HIE," said Deborah L. Rice, Highmark's executive vice president of health services. "At the very core of this HIE is improved patient care, and that's the foundation of what our customers want from us and their care providers. It's about working collaboratively as a health care community and using the available health care data to provide the best possible care."

As the push to transform health care through technology takes hold, health information exchanges are gaining acceptance.  Health care organizations of all sizes and types are using HIEs to overcome the long-standing obstacle of incompatible health IT platforms and software used to store patient data.  By facilitating the secure and compliant retrieval and sharing of patient clinical data among participating hospitals, clinics, physician practices and health care plans, the technology helps enable the quality, safety and efficiency of patient care.

"Health information exchanges address many of the interoperability, security and compliance issues that have long impeded the sharing of digital clinical information across the health care ecosystem," said Dr. Peter Tippett, vice president and chief medical officer, Verizon Connected Healthcare Solutions, the company's health IT practice group.  "The work we are doing with Highmark underscores the potential health IT has to drive the development of patient-centered care models by unlocking the value of clinical information that's accessible across communities, regions and health care providers."

The Highmark HIE will be powered by the Verizon Health Information Exchange, an interoperable health IT platform delivered via Verizon's cloud-computing infrastructure.  The platform consolidates patient clinical data from disparate providers and translates the information into a standardized format for secure access over the Web, offering health care professionals an effective way to obtain a more complete view of a patient's health history.  The platform uses strong identity-access-management controls to provide security for sensitive patient information and enables members to retain their existing systems, processes and workflows, thereby reducing the need for additional capital expenditures. 

Highmark also has leveraged the expertise of Accenture, a global leader in management consulting and technology services, to assist health care providers with connecting to Highmark's HIE, which has been in development for the past 18 months.

About Highmark Inc.

Highmark Inc., based in Pittsburgh, is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Highmark serves 4.8 million members in Pennsylvania and West Virginia through the company's health care benefits business and is one of the largest Blue plans in the nation. Highmark has 19,500 employees across the country. For more than 70 years, Highmark's commitment to the community has consistently been among the company's highest priorities as it strives to positively impact the communities where we do business. For more information, visit www.highmark.com.

Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information, visit www.highmark.com.

About Verizon

Verizon Communications Inc. (NYSE, Nasdaq: VZ), headquartered in New York, is a global leader in delivering broadband and other wireless and wireline communications services to consumer, business, government and wholesale customers.  Verizon Wireless operates America's most reliable wireless network, with nearly 109 million total connections nationwide.  Verizon also provides converged communications, information and entertainment services over America's most advanced fiber-optic network, and delivers integrated business solutions to customers in more than 150 countries, including all of the Fortune 500.  A Dow 30 company with $111 billion in 2011 revenues, Verizon employs a diverse workforce of nearly 194,000.  For more information, visit www.verizon.com.

VERIZON'S ONLINE NEWS CENTER: Verizon news releases, executive speeches and biographies, media contacts, high-quality video and images, and other information are available at Verizon's News Center on the World Wide Web at www.verizon.com/news.  To receive news releases by email, visit the News Center and register for customized automatic delivery of Verizon news releases.

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The Health Information Technology Exchange of Connecticut (HITE-CT) Selects Axway and GE Healthcare for HIE Solution

Tue, Feb 21, 2012, 6:32 AM EST - U.S. Markets open in 2 hrs 58 mins

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Neb. bills offer health insurance exchange plan

LINCOLN, Neb. (AP) — Work on Nebraska's own version of health care insurance reform will begin in earnest next month when bills to create the Nebraska Health Benefit Exchange Act come up for debate, two state lawmakers said Tuesday.

Sen. Rich Pahls of Boys Town and Sen. Jeremy Nordquist of Omaha each have introduced a bill in hopes of having a state law in place before the U.S. Supreme Court rules on the federal health care reform plan this summer.

"The nuts and bolts of the two bills are not really that different, from what I have read," Nordquist said. "We are not dictating a lot in the bills. We are leaving a lot of it up to others to bring their recommendations to us. We are not overly descriptive at this point."

Both bills would create the benefit exchange act, which is aimed at providing health insurance options for Nebraskans to buy affordable, quality health care coverage.

Among the goal areas in the bills:

— Increasing access to quality, affordable health care coverage.

— Reducing the number of uninsured Nebraskans.

— Providing affordable options for small businesses to purchase private health insurance for their employees.

— Providing consumer choice and portability of health insurance, regardless of employment status.

"My bill would move us forward in the establishment of a health insurance exchange, which is an open, transparent marketplace for consumers, families and small businesses to shop for the plan that best fits them," Nordquist said.

Nebraska is among the many states that are working on their own laws instead of waiting for the Supreme Court.

Oral arguments are set for March on whether the federal plan requiring nearly all Americans to buy health insurance by 2014 or face financial penalties is unconstitutional.

Pahls said it's important for Nebraska to have an insurance plan completed before summer. But it's also important that all interested parties from consumers to health care providers to insurance carriers have input.

"We want to make this public and see where everyone is at, so we can find some commonality," Pahls said. "Because everybody has a stake in it."

"I don't know where this will lead us right now, but it will give us an opportunity to talk about it."

Nordquist said the bills were offered as a starting point and voices from all sides of the issue will be needed as the state moves into new territory.

"This is the first time that the state is setting up a process to sell a private product," he said.

"I'm hopeful that we can move as soon as possible," Nordquist said. "The longer we wait, the less likely we will get it right. The sooner we get to work, the better it will be for Nebraskans."

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Legislative Bill 835

Legislative Bill 838

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State health exchange hits snag

The GOP-run state House of Representatives is holding up legislation pushed by Gov. Rick Snyder to create a Michigan health insurance exchange, which threatens to leave the state with a federal marketplace where consumers shop for health coverage.

Many House Republicans are rejecting the wishes of their fellow GOP governor, arguing that they don't want to prematurely install federal health requirements they consider faulty and unconstitutional.

State House Speaker Jase Bolger, R-Marshall, said Friday that the House wants to wait until after a U.S. Supreme Court ruling on President Barack Obama's federal health reforms to decide its next steps on the exchange.

"The governor and I are not in agreement on this issue," he said. "The rights of our citizens to control their own health care is more important than an IT (information technology) deadline."

Michigan Attorney General Bill Schuette is supporting the legal effort to get the federal reforms declared unconstitutional.

State Rep. Chuck Moss, R-Birmingham, who chairs the House Appropriations Committee, also said the GOP caucus doesn't want to act unless it has to.

"We don't like Obamacare; we don't like national health care. We don't think it's good for the country; we don't think it's good for Michigan," Moss said. "We don't want to be early adopters and go down that road if we don't have to."

But if a Supreme Court decision isn't made until late June — normal for high-profile cases — some proponents of a Michigan exchange fear the state won't meet a Jan. 1, 2013, deadline to create its own exchange — essentially a website such as Orbitz.com or Travelocity.com for consumers and small businesses to compare and enroll in health insurance.

A federally created exchange could limit consumer choice, with possibly only major national carriers on the exchange, said Rick Murdock, executive director of the Michigan Association of Health Plans, which represents 17 health plans covering more than 2.1 million Michigan residents.

"We may be left with a system that doesn't work best for Michigan," Murdock said.

Snyder wanted legislation for a state exchange by Thanksgiving. In November, the state Senate approved legislation to create the MiHealth Marketplace — a clearinghouse of insurance information that would be run by a nonprofit and paid for by user fees from insurance companies. But the House didn't act.

Snyder last week in his State of the State address called on the Legislature to approve an exchange, cautioning that not acting will result in a program designed by the federal government instead of Michiganians.

The state estimates about a half-million people would use a Michigan exchange to buy coverage, many of whom will be eligible for federal subsidies to help buy health insurance.

An estimated 400,000 to 600,000 additional state residents will be eligible for Medicaid under health care reform changes coming in 2014 and could use the exchange to enroll in the health program for low-income residents, Murdock said.

The subsidies will be available for individuals and families who meet income requirements, including up to $89,400 for a family of four, who aren't eligible for employer coverage or coverage through a government program.

The Urban Institute, a nonpartisan research group in Washington, D.C., estimates that $1.3 billion in subsidies will flow through Michigan's exchange in 2014, according to the state.

This past week, the state House Health Policy Committee heard testimony from the public on creating an exchange, one of about 10 weeks of testimony so far on the issue, said Rep. Gail Haines, R-Waterford Township, the committee chairwoman.

Haines said the committee is taking a deliberative approach, but if the Supreme Court finds health reform constitutional, the House will be ready to act.

"Rest assured, we are not going to have this run by the federal government," she said.

But in December, the House did not include appropriation for about $9.8 million in federal government funding the state was granted in November to further efforts to create an exchange. The state has 12 months to spend the money, said Steven Hilfinger, director of the Michigan Department of Licensing and Regulatory Affairs.

While almost $10 million hangs in the balance, the state faces a June 29 deadline to apply for a second federal grant to pay for creating the exchange. That application requires the state to have passed legislation for a health exchange.

"This is a very complex IT project," Hilfinger said. "It includes a lot of interfaces with the business community, with health care insurers, with health care providers, the federal government."

Some Republicans fear the delay could be costly. State Sen. Jim Marleau, R-Lake Orion, who introduced the Senate health exchange bill, said a state exchange will allow for competition and help keep health insurance rate increases smaller.

"We're losing one by one the days that we control our destiny," Marleau said.

Michigan Consumers for Healthcare, an organization including groups such as the Detroit Wayne County Health Authority and AARP of Michigan, also wants immediate action on legislation and approval of an appropriation for the grant money.

Delays on a health information exchange for the uninsured could lead to confusion among consumers, Murdock said.

"That confusion can lead toward disappointment, anger even," Murdock said. "We're going to take the heat for it, even though it's largely due to actions that are beyond our ability to control."

mburden@detnews.com

(313) 222-2319

Q. What is a health exchange?
A. It is a government-required place where consumers without health coverage can find information about health insurance plans in their state.
Q. When will the health exchange start?
A. In 2014.
Q. Why must the Legislature make a decision on creating an exchange?
A. Federal health care reforms require it. States can set up their own by a Jan. 1, 2013, deadline or let the federal government set up one for them.
Q. How might a state exchange work?
A. The Michigan Senate’s proposed exchange would operate similar to a website such as Orbitz.com or Travelocity.com for health insurance. Consumers and small businesses could learn if they qualify for federal subsidies to help with premiums, compare coverages and enroll in health plans.
Q. Who would run and monitor the proposed state exchange?
A. It would be run by a by a nonprofit and overseen by an independent board of seven members — five appointed by the governor, one by the Senate majority leader and one by the House speaker.
Q. How much would it cost for the state to create the exchange?
A. The state doesn’t have an estimate on the cost.

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Otter Not doing health exchange would be $300 million hit.mp4

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