title: Capitalizing the NHIN: a strategy for funding an integrated nationwide network of community HIEs.
abstract: Lack of capital investment is limiting progress towards NHIN goals. A 10-step strategy for engaging new private-sector investment is presented. The vision involves developing an integrated nationwide network of community health record banks that contain costs and improve quality through robust community-wide process improvement efforts. Purchasers, such as employers, Medicare and Medicaid, jump-start the process, beginning with pilots, by making advance commitments of low per-member per-month fees for 10 percent to 30 percent of each community's population. Additional revenue opportunities are identified, includin value-added services for consumers, pharmaceutical manufacturers and providers. Competing for-profit service providers then are offered exclusive multi-year contracts to build and operate the community health record bank using a revenue share contract. After they're selected, service providers invest capital to build record bank technologies, services and infrastructure. Successful service provider gain opportunities to develop record banks nationwide. To achieve success, the private sector, and federal and state purchasers must work together to support robust community-wide pilots.
authors.affiliation: Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, University of Louisville, USA.
authors.forename: Judah
authors.initials: J
authors.lastname: Thornewill
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Esterhay
mesh_terms: D005381:Financing, Organized / Q000379:methods*; D007256:Information Systems / Q000191:economics*; D008498:Medical Record Linkage; D017146:Models, Organizational; D017149:Private Sector; D018511:Systems Integration; D014481:United States