LINCOLN — The state’s health information and prescription drug procurement provider says its services to doctors and hospitals are in jeopardy because the state can’t pay in full on a $15 million-a-year contract.
The lack of payments to CyncHealth prompted the organization’s board — a group of hospital and health care administrators — to “beg” the Nebraska Department of Health and Human Services to meet its obligations and operate a data-sharing network.
DHHS has signed a contract with La Vista-based CyncHealth to provide a statewide Health Information Exchange (HIE) that documents a patient’s past treatments and health records with the goal of improving health outcomes. CyncHealth also operates a prescription drug monitoring program (PDMP) that tracks drug purchases to prevent “doctor shopping” for duplicate prescriptions of dangerous opioids like oxycontin.
The letter, sent on September 16, said the lack of payments was an example of poor planning by the state and “avoidable red tape”.
“If providers fail to access the HIE or PDMP, they will be prevented from providing optimal care to their patients, putting the health of Nebraskans at risk,” the letter added. “We ask that you meet your funding obligations…”
Letter signed by hospital officials
The letter was signed by CyncHealth’s 17 board members, which include representatives from the state’s major health care providers, including Nebraska Methodist, CHI Health, Nebraska Medicine and Children’s Hospital, all of which use health data.
Nebraska DHHS spokesman Jeff Powell said in an email Thursday that the federal Medicaid programs, which fund 90% to 100% of HIE and prescription drug program costs, have “changed significantly” over the past year. in some cases it has ended.
That, Powell said, left DHHS free to pay CyncHealth in full — about $11 million short on a $14.6 million contract that runs through the end of September. The contract includes a one-year extension through September 2023 for $18.9 million.
The agency paid CyncHealth for its prescription drug monitoring program through July, he said, but he said the state’s $1 million allocation for HIE was in excess. CyncHealth President and CEO Jaime Bland estimated that the state will owe CyncHealth about $11 million by the end of September.
Powell added that DHHS has committed to seeking a deficit appropriation from the State Legislature to meet the remainder of its contract obligation.
The answers left CyncHealth officials scratching their heads and scrambling to make ends meet as to why they weren’t getting paid.
He is forced to borrow
Bland said his company has had to borrow money to continue paying its 75 employees and is unable to pay some technology providers.
The lack of payments hurt its credit rating, Bland added, and threatened that CyncHealth could continue to report health care providers — providers it says had paid their bills early — to keep the operation going.
In August, CyncHealth said health care providers viewed 637,463 records stored in its HIE. Over the past 12 months, the Veterans Administration and Department of Defense reviewed 5 million records submitted by the Nebraska HIE nationwide.
Bland said DHHS is aware federal program changes are coming, and the agency can use state appropriations to match federal funds through new programs. The Legislature won’t consider deficit appropriations until January, putting CyncHealth even further in the hole, he said.
“It doesn’t make sense what they’re doing,” Bland said.
New federal funds
Powell acknowledged that new federal funding options are available for DHHS to pay for electronic health records, but he said they have not offered matching funds. He added that the agency could not enter the current budget on time, and could not calculate how much more state funds might be needed to close the gap.
Doctors and hospitals across the state and country use the Health Information Exchange to track a patient’s past health records and what treatments he or she received at other facilities.
The prescription drug monitoring program was a priority for former state Sen. Sarah Howard of Omaha, whose sister died of a prescription drug overdose. The idea is to track how often opioids are prescribed to patients and purchased by patients, stopping “doctor shopping” and access to unsafe amounts of the drug.
The two programs are funded by a combination of state and federal funds, with some fees paid by health care providers.
La Vista state Sen. John Arch, who chairs the Legislature’s Health and Human Services Committee, which oversees DHHS, said the agency is still trying to address federal funding changes that have led to the payment problem.
‘Nothing is simple’
“There’s nothing simple about federal funds,” said Arch, whose district includes the CyncHealth office.
“The issues must be resolved so that CyncHealth has a sustainable and predictable source of funding.”
Arch, a former health administrator, called the HIE a “tremendous resource” for both treatment and research, which has the potential to “move the needle” on disease treatment as well as reduce health care costs.
Arch added that he believes the financial issues will be resolved.