What is the return on investment (ROI) for participating in a health information exchange (HIE)?

Simply stated, ROI measures the benefit (or return) an investment generates in relation to the cost of the investment. The HIE ROI answer is different for each organization.

While the ROI calculation can be framed in financial performance terms – if it costs XX to participate in the HIE, what is the dollar return to a practice or facility?

ROI value can also mean increased productivity and efficiency, minimal disruption to workflow, and improvements in care. Or, for a facility, ROI can mean improvement in risk adjustment scores and quality metrics.
 

 

Physicians – let’s talk about your ROI from HIE participation!

• Patient records are up-to-date;
• Lab work and medications are current;
• Increased efficiency for physician and staff.

Your office may save 15 minutes per patient per day which means one additional patient may be seen daily.

This benefit compared to the HIE investment costs may potentially realize a gain of $1.30 for every $1.00 invested in Year 1. In Year 2 and thereafter, the practice may realize a gain of $9.00 for every $1.00 invested.

OneHealth New Jersey can help you do the math to see what gains might be achieved for your practice!

OneHealth New Jersey provides physicians with the tools to:

• Utilize patient panel and population health analytics in a meaningful way;
• Effectively transition to a value-based payment model; and
• Support efforts to meet requirements for MIPS/APMs.

Hospitals – let’s talk about your ROI from HIE participation!

Better care. Access to more complete, longitudinal patient data in the HIE results in better clinical assessment and care planning because:

• Patient records are up-to-date
• Problem list complete
• Lab work, vitals and medications current

Improved revenue. The opportunity to capture significantly richer clinical documentation enables coding that more accurately reflects severity of patients’ conditions, which can result in improved revenue through higher case mix index (CMI) and risk adjustment scores (RAF).

By including HIE data, one medium-sized PPS hospital recently participated in a retrospective study which demonstrated the potential for an average CMI increase of .44 though better coding, which would have represented an increase of $90,000 in MS-DRG payments annually. That same hospital could also have documented a 75% RAF increase for its Medicare Advantage patients, resulting in significantly higher revenue. The potential financial benefits far outweigh the cost of HIE participation.

Patient ROI

Physicians can be influential when it comes to a patient’s healthcare data and encouraging them to securely access their information to improve health outcomes. OneHealth New Jersey participating physicians, hospitals, and other healthcare-related entities, can share patients’ health information through a secure, electronic health information network.

The Physician/Patient Relationship ROI

OneHealth New Jersey provides tools to enhance the physician/patient relationship:

• Access patient information in a timely, secure manner to improve patient visits;
• Improve care coordination and patient safety;
• Increase physician/patient communication.

 

Frequently Asked Questions?