At the May meeting of the National Association of State CIOs, HHS Secretary Mike Leavitt had some bad news about Medicaid:
"Medicaid expenditures will exceed public education expenditures for the first time this year. If health care begins to push out all other priorities, it throws off the economic equation."
For most states, public education is the lion's share of the budget and is viewed as an investment in the future. Seeing that crowded out by something else, even something with as noble a purpose as health care is troubling.
Leavitt, true to form, challenged the State CIOs to use technology to help solve the problem and lower health care costs. You may wonder what your state government can do to lower health care costs. I believe they can do a lot.
A few states, like Utah and Massachusetts have state-wide "networks" for interchanging health care information. Utah's network, UHIN, has been providing doctors and insurers a standardized way to exchange payment information for years. Now, UHIN is part of an HHS pilot project to use that same network to exchange clinical information as well.
If you're familiar with exchange points on the Internet, you can think of these health information networks in much the same way. Someone has to connect the various payers and payees together, but it's difficult to imagine who's job it is, who sets the standards, and so on. State's can play a significant role in bringing the various parties together and serving as an honest broker.
The technology to make this happen isn't difficult. The real problems are political and economic. State CIOs can use their "convening authority" to help break down those political and economic barriers and, with some luck, remove some of the overhead from the health care system.