Paying for data could help incentivize interoperability, athenahealth says

Jump-starting interoperability among healthcare providers could get a boost from creating an economic value for data.

That concept is the suggestion of electronic health record vendor athenahealth. In a comment letter to the Centers for Medicare and Medicaid Services, the company offers the idea that interoperability could be facilitated if providers saw direct economic value from exchanging it.

“To promote interoperability between disparate healthcare organizations, CMS should create a new carve out to Stark and Anti-Kickback laws to allow physicians to make and receive fair market value payments, which would be nominal, for the exchange of important and usable information for patient care,” contends Greg Carey, director of government and regulatory affairs at athenahealth, in a letter to HHS Inspector General Daniel Levinson.



Such exceptions would allow for true functioning market for the exchange of health information, he says.

The time has come when every certified EHR can meaningfully exchange data with another certified EHR, Carey contends, so interoperability can no longer be considered a technical problem. “Nevertheless, the industry lack widespread interoperation of critical data due to misaligned business incentives,” he adds.

Also See: Cleveland provider, payer start to exchange data electronically

In most industries, businesses in need of data pay fair market value for the transmission of data, which creates and maintains a technological infrastructure to enable secure and efficient data exchange.

In healthcare, patient data is most often exchanged in the form a referral, and a transfer of value is unlawful under Stark and Anti-Kickback laws.

“As a result, the owner/curator of quality data is obliged to assume the cost of electronic transfer of information to a recipient,” Carey explains. “The beneficiary of the work and the infrastructure investment necessary to curate that data and enable the secure and efficient transfer of the data—the recipient—is prohibited from paying fair market value for that work and investment. This paradigm, which forces the curator of data to pay for the privilege of sending data electronically to a recipient, operates as an effective economic disincentive to information sharing in healthcare.”

And that disincentive burdens clinicians and impedes efficient delivery of quality care to millions of Medicare beneficiaries, Carey tells CMS.

The complete letter is available here.