Health information exchanges (HIE) have been plagued by questions of funding in recent months. But there's another issue on a lot of people's minds: How will they thrive in the changing health care landscape?

"We can't have it be profitable to hoard patient information. But we should make it profitable to share information," said Dr. Farzad Mostashari, the head of ONC, during a webinar on Wednesday that included over 1,000 participants.

HIEs were funded originally by the 2009 American Recovery and Reinvestment Act. They enable providers to share patient data electronically and in a secure fashion. To date, there are 119 in use.

Since HIE should follow the patient, care coordination on the provider side needs to be rewarded, according to Mostashari. Not only does ONC intend to develop and implement policies and programs to encourage providers to exchange HIT through interoperable systems in support of care coordination, but the agency said it will work closely with the Centers for Medicare and Medicaid Services going forward to align payment incentives toward steering HIT in this direction.

ONC sought public input from a variety of providers, consumers and industry stakeholders on what policies might strengthen the business case for HIT across care coordination, such as requiring HIE in all advanced payment models as well as Medicaid waivers.

According to Dr. Patrick Conway, chief medical officer at CMS and the new director of its Innovation Center, CMS has taken action to accelerate HIE and interoperability as well. For example, in the new physician fee schedule that was just released, CMS proposed new chronic care management fees on e-summaries of the record exchange.

"Overall it's aligning our programs and policies with sharing of electronic health information to improve care and lower costs," said Conway.

In addition, CMS' new innovation center's second round of awards will focus on new payment models that support HIT.

"HIT and HIE are the building blocks of health care transformation," said Conway.

Based on the public feedback, Mostashari also highlighted some other ways ONC will be committed to improving HIE going forward. This includes fixing the gaps in ONC's current approach to interoperability across the entire spectrum of care that must also include home health care, long term care and behavioral health.

On a separate note, Mostashari announced on Tuesday that he will step down this fall from his position as head of ONC.

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