Nebraska advances insurance exchange despite politicians' health reform view

By Mary Mosquera
12:21 PM

A come-from-behind finish by a little known candidate in Nebraska’s Republican primary for U.S. Senate catapults the state to a decisive role in whether that body will lose its slim Democratic majority.

Deb Fischer, a Nebraska state senator and rancher, overtook the two leading establishment GOP candidates in the May 15 primary with endorsements by Tea Party favorites Sarah Palin, former Alaska governor, and Herman Cain, former Godfather’s Pizza CEO and GOP presidential candidate, and some last minute political action committee money. Talk about Tea Party waning influence may be premature.

Fischer will face off with former Nebraska Democratic senator and governor, Bob Kerrey, in November to replace retiring Democratic Sen. Ben Nelson. 

One thing all the GOP U.S. Senate primary candidates agreed on was health care--repealing the health reform law, even those popular provisions that are already in place, limiting medical malpractice to lower healthcare costs, and allowing consumers to buy health insurance across state borders.

Nevertheless, Nebraska is studying options for its health insurance exchange, including receiving $6.5 million planning and establishment grants, despite signing on to the lawsuit challenging the health reform law.

[Podcast: The uncertain future of health insurance exchanges.]

Gov. Dave Heineman said Nebraska will develop its own insurance exchange but won’t start until Supreme Court rules in June in the event the justices strike down the Patient Protection and Affordable Care Act. 

In his state of the state earlier this year, Heineman said, “I want to assure you that Nebraska will not default to the federal government regarding a health insurance exchange. The simple truth is it would be a costly mistake to spend millions of taxpayer dollars to begin implementing Obamacare until the United States Supreme Court makes its decision.”

At the same time, Nebraska is moving progressively on healthcare IT, including a thriving health information exchange, with participation by a growing number of providers and health insurance companies.

The Nebraska Health Information Initiative (NeHII) offers an online system to electronically display personal health and medical information securely between doctors, hospitals, and other health care providers for patient care.

Regional West Services of Scottsbluff, Neb., is the most recent provider to join the state HIE in April, starting with its physicians’ clinic independent laboratory and Regional West Medical Center.

This paves the way for health information exchange in western Nebraska, said Dr. Harris Frankel, president of the NeHII board of directors, in announcing the participation expansion. “Physicians and other providers in western Nebraska will soon realize the benefit of being able to access information at the point of care to improve the quality, safety, and efficiency of care for their patients,” he said.

NeHII also began letting participating physicians access to electronically share patient immunization information to the Nebraska State Immunization Information System (NESIIS), which connects and shares immunization records among public clinics, private provider offices, local health departments, schools and hospitals.

Immunization information is currently shared among physicians using NeHII. Integrating NESIIS into the exchange to share immunization information is expected to foster more accurate and up-to-date immunization records, said Dr. Joann Schaefer, chief medical officer for the Nebraska Department of Public Health.

“This is only a step in proving the value of electronic health information sharing, and it is going to improve our vaccination rates and save more lives over time,” she said.

For one-to-one sharing, NeHII is conducting a pilot to exchange lab results with a rural health clinic using the Direct protocols for secure messaging.

Nebraska is also one of six states whose health information exchange has taken on a challenge from the Office of the National Coordinator for Health IT to increase consumer access to their health data.

NeHII and SimplyWell, a health and wellness management service, are using the Blue Button technology from the Veterans Affairs Department to enable patients to obtain their health information electronically from NeHII and download it to a personal health record to use it in innovative ways.