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AHS and stakeholders press for clarity on data, privacy and interoperability in health information exchange section
Summary
Agency of Human Services and Green Mountain Care Board staff said section 8 of the bill is a major step but asked for clarifications on standards, systems, and how clinical and claims data will be linked to support payment reform and monitoring.
Agency of Human Services and health information stakeholders used the Health & Welfare committee session on March 13 to seek clarifications and small drafting changes to section 8 of the committee bill, which creates or expands state-level health information exchange and data linking to support payment reform and monitoring.
Will Dempsey, health data officer for the Agency of Public Service, told the committee that section 8 is “a big step forward” but recommended a few drafting adjustments to avoid locking the statute to specific system names or short-lived best-practice language. “Our personal preference would be to focus on the standards,” Dempsey said, recommending reference to evolving federal standards rather than a static set of “best practices.”
Monica Hoville, state scientific director and member of AHS’s executive leadership team, told the committee that AHS supports the section’s intent but asked for clear boundaries so the AHS retains Medicaid oversight and the Green Mountain Care Board’s hospital finance role remains intact. “AHS maintain a priority over all things related to the Medicaid program,” Hoville said, while also urging collaboration to avoid duplicative or conflicting work.
Key technical concerns included: - Naming and system references: Dempsey recommended avoiding linkage to specific system names (for example, the All Payer Claims Database software) because systems can change. He urged lawmakers to reference claims and clinical data generically and to allow the board and agencies to decide how to integrate them. - Security and privacy: Stakeholders asked the committee to reference federal security and privacy standards rather than a looser “best practices” standard to maintain a consistently high bar as federal rules evolve. - Scope of data: Will Dempsey and AHS asked the committee to broaden the language to include clinical data, social drivers of health, and other nonclaims sources that would support population-level monitoring and payment reform. Dempsey noted the state’s Medicaid analytics platform (referred to in testimony as the Medicaid data warehouse analytics solution, MDWAS) will be a foundation for that work.
Why it matters: Committee staff and witnesses agreed that building robust linked data will be essential to evaluating reference-based pricing and global budgets. Witnesses warned that poor or misaligned data policy could hamper evaluation and create extra operational burden for hospitals. AHS recommended collaboration with the existing health information exchange steering committee and OneCare Vermont, and suggested the advisory body be kept small and agile while ensuring participation from relevant agencies and provider types.
Next steps: The committee asked staff to incorporate edits to focus on standards rather than best practices, avoid naming specific systems in statute, and clarify AHS and Green Mountain Care Board roles. AHS offered to return to the committee with additional technical language and to present progress on related analytics work as the bill moves forward.
