In 2010, Government Technology’s sister publication, Public CIO, ran a story about how state CIOs were starting to pay more heed to health-care issues. The article quoted CIOs who were getting crash courses in EHRs (electronic health records), HIEs (health information exchanges) and MMIS (Medicaid management information systems).

Add another acronym to the list: HBE (health benefits exchange). It’s a term state CIOs — along with various agency CIOs — will become familiar with in the next few years. HBEs are online insurance marketplaces that let citizens shop for affordable health coverage and offer free or subsidized plans to those who qualify. States are required to operate an HBE by January 2014 under the federal Affordable Care Act.

As this month’s cover story points out, this deadline already is causing headaches among state technologists. Deploying an HBE requires complex connections between the online marketplace and Medicaid eligibility systems, and the new HBEs also must link to a still-undefined federal data clearinghouse designed to verify eligibility.

Until the details are resolved, state officials say it’s tough to be confident about meeting the federal mandate. That’s true even in Utah, one of two states that already have operational HBEs. “It’s really hard to say that we are going to make the timeline because we don’t know ... all of the components at this point,” said Patty Conner, director of the Utah Health Exchange.

Given these issues, it’s no surprise that addressing health-care information needs ranks among the top goals for state CIOs. One-third of CIOs ranked health IT as a top priority in a survey released in October by NASCIO, TechAmerica and Grant Thornton.

But the survey also shows that many state CIOs struggle to understand how they fit into the evolving health-care landscape. “I could be a coach or an adviser on process, or I could be a hosting service provider,” said one survey participant.

Their roles may still be cloudy, but one thing’s clear: CIOs must engage in process. Health-care costs are the fastest growing budget expense for states. Health care also is a key policy issue for governors, many of whom are focused on improving quality and services. Smarter use of health IT offers the chance to control health costs while expanding coverage — and state CIO involvement in these projects helps ensure they’re implemented broadly and sustainably.

Luckily 82 percent of CIOs surveyed said they’re involved or expect to be involved in their state’s HBE development and deployment. More than half of respondents also said they’d consider collaborating with other states on system models or technology for HBEs. That’s good news. As health-care systems become dominant in state IT portfolios, CIOs can ill afford to sit on the sidelines.

Steve Towns, Editor Steve Towns  |  Editor

Steve Towns is editor of Government Technology, and executive editor for e.Republic Inc., publisher of GOVERNING, Government Technology,Public CIO and Emergency Management magazines. He has more than 20 years of writing and editing experience at newspapers and magazines, including more than 15 years of covering technology in the state and local government market.