Who should pay for RHIO infrastructure and service development?
The most critical issue is who should pay for the investment funds needed to develop RHIO infrastructure and services to a stage at which the RHIO can offer services to participants that will then cover at least part or all of the marginal cost of the service. In some communities, private health care organizations may easily agree on covering most or all of the marginal cost of some services with a favorable private value proposition but disagree on paying for initial HIE infrastructure and service-development costs. Public funding typically is an option where many potential parties must coordinate investments, benefits are uncertain, and societal and private value propositions diverge, as is the case for RHIO development. Certainly, public funding would be needed to pay for HIE services with a favorable societal but not private value proposition. Health care payers could directly contribute to RHIO development by paying for HIE data provision or provider use, for quality performance t
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