Political Will for Health Information Exchange Is Strong in California; Funding Is Needed

By Timi Leslie

The need to share health information with our caregivers, care coordinators, and public health teams has never been more acute. The COVID-19 pandemic uncovered how unprepared we are to orchestrate a swift, effective, and just response that puts resources where they are needed most. Without modern health data sharing capabilities across the state, we continue to struggle with the lack of access to real-time testing results, vaccination status, and insights at the population level to elevate gaps in care.

California’s vast geography, competitive health care markets, and diverse financing and delivery systems have challenged the vision of the right data available at the right time for decades. For the first time in my career in health IT, we have many of the necessary underpinnings to bring this vision into reality.

With the passage of AB 133, our state health leaders committed to developing the first-ever statewide Health and Human Services Data Exchange Framework, a set of guiding principles, single data-sharing agreement and common set of policies and procedures governing the exchange of health information among health care entities and government agencies. As of January 31, 2024, most health care providers and health plans are required to sign the Data Sharing Agreement to facilitate seamless and secure data sharing.

This strategy is bold and meets the moment, however it is missing an essential component: secured funding to ensure the long-term viability of quality-based, equity-driven statewide data exchange. The financial burden of ensuring sustainability can’t sit on payer, provider and community based organizations alone.


Others states have shown us the way with a funding blueprint

Arizona and Colorado are two of many states that have achieved statewide health information exchange success. And they are continuing to invest by accessing needed federal matching funds and not only sustain the data sharing network, but expand services and improve data quality.

Arizona’s state Medicaid program developed a differential adjusted payment program that incentivizes providers to share data with the state’s health information exchange, and to improve data quality. Colorado has shifted its financing for health information exchange away from previously available ARRA-HITECH funds to Medicaid Management Information System funds, with available federal match ranging from 75% to 90%.


California should also take advantage of available federal funds 

California has successfully managed other health information exchange incentive programs before, including the recent California HIE Onboarding Program (Cal-HOP), and should invest again in statewide data exchange. At the local level, health plans and providers have invested in this work–including the Inland Empire Health Plan with its pay-for-performance program that incentivizes participation in the Inland Empire Health Information Organization. But funding from providers and plans alone won’t make this work sustainable and it certainly will not bring forward the vision that every Californian and their providers have the information and insights they need to make healthcare seamless, high quality and affordable.

Connecting for Better Health and our coalition partners are profoundly grateful to Governor Gavin Newsom, Assemblymember Jim Wood, State Senator Dr. Richard Pan, and others who championed passage of AB 133. Political will to establish a framework for statewide data exchange remains strong, but our state leadership must go a step further and develop lasting funding mechanisms to build a strong data sharing foundation and continuously improve.

Along with our coalition participants, we are dedicated to advancing health information in California. We support multi-stakeholder efforts to include a $95 million General Fund allocation for Medi-Cal performance payments and health information exchange organization (HIO) health data infrastructure that is estimated to be matched by $160 million in the next fiscal year.


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