The Mass HIway’s pricing philosophy continues to ensure all providers have affordable access to the exchange of health information through the Mass HIway. Mass HIway services are flexible in terms of the services participants can access and to the ways in which these services are deployed.
Mass HIway pricing is designed around this flexibility. Participants may connect to the Mass HIway directly through their electronic health record if available, or through a Connect Device, or via HIway Webmail. For more information about connection methods, click here. Participants may access the Mass HIway through a single node (connection) or through multiple nodes.
Prices have two components:
- One time set up fee
- Annual services delivery fee
The annual HIE services delivery fee is based on the participant's connection type(s) and number of connections. HIE services fees are fixed regardless of message volume, message size, number of users or number of underlying organizations. For example, a legal entity with multiple sub-organizations - e.g. Integrated Delivery Network - may purchase a single node and take responsibility for all onward message handling.
Webmail fees are fixed per mailbox and subject to storage and message size restrictions.
Prices DO NOT include cost of modifying the Electronic Health Record (EHR) or other IT system to meet Mass HIway integration requirements. Participants are responsible for modifying their EHR or IT systems as needed.
Fees are tiered into categories based on participant organization size and type as noted below.
Mass HIway encourages Technical Integrators to assist participants to connect to the Mass HIway. In general, the Technical Integrator will not be charged a fee. However, a Technical Integrator may pay fees on behalf of the participants it connects to the Mass HIway. If the Technical Integrator pays the fee on behalf of the participant, it will be considered a "Tier 1- Multi Entity HIE" type. This rate allows a Technical Integrator to connect as many participants as they like.
If a participant wishes to act as a Technical Integrator on behalf of trading partners or other related entities, and the participant plans to pay on behalf of the additional parties, the participant would be charged the "Multi Entity HIE" fee and will not be charged separately as a participant.
Mass HIway does not charge for Health Information Service Providers (HISP) connections nor does it charge organizations to connect to the Mass HIway via a HISP.
A participant may purchase an extra Connect Device for its test environment. The Test Connect Device annual fee is $10,000 for a large device or $3,000 for a small device.
More information can be found in section 14 of the Mass HIway Policies and Procedures.
Mass HIway Rates - Effective December 1, 2017
Pricing Categories Definitions
| Tier | Category Definition |
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Tier 1 |
Large hospitals/Health Systems: Large hospitals include teaching hospitals and/or large health care delivery systems. Includes: Baystate Health, Beth Israel Deaconess Medical Center, Boston Medical Center, Cambridge Health Alliance, Boston Children’s Hospital, Dana-Farber Cancer Institute, Lahey Health, MEEI, Mount Auburn Hospital, Partners HealthCare, Saint Vincent Hospital, Steward Health Care, Tufts Medical Center, UMass Memorial Health Care. Small hospitals include all others. |
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Health Plans: Health insurance carriers. |
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Multi Entity HIE: Health Information Exchange (HIE) networks that include more than one authorized legal entity (e.g., NEHEN, SafeHealth, Wellport). |
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Technical Integrator: Connects multiple entities other than members of a MassHealth ACO, or a MassHealth CP or CSA consortium. See 14.1.1 Pricing Considerations for details. |
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Commercial Imaging and Lab Centers: Standalone imaging and lab centers as defined by Massachusetts state licensing and not included in larger health systems. |
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Tier 2 |
Small Hospitals: Hospitals or Healthcare systems not included in list of Large hospitals/Health Systems above. |
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Large Ambulatory practices: Practices with 50 or more licensed providers (MD/DO/NP/PA) in a single legal entity regardless of number of sites, and not otherwise included in larger systems (i.e. not employed or owned by a hospital or health system). Category does not include federally qualified health centers (FQHCs) or FQHC look-alikes. |
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Large Long Term Care entities: Nursing homes or nursing home systems with 500+ licensed beds (e.g., Kindred, Genesis, Golden Living Center, Wingate, Life Care Centers, Epoch Senior Healthcare, Radius Healthcare, Beaumont). |
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Ambulatory surgical centers: As defined by Massachusetts state licensing. |
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Ambulance and Emergency Response: Standalone emergency medical service providers as defined by Massachusetts state licensing and not included in larger systems. |
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Business Associate Affiliates: Business associates of participant covered entities. |
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MassHealth ACO, CP, or CSA Technical Integrator: Connects all members. See 14.1.1 Pricing Considerations for details.
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Tier 3 |
Small Long Term Care entities: Nursing homes or nursing home systems with <500 licensed beds. |
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Large Behavioral health: Standalone mental health or counseling clinics with 10+ licensed providers and not included in larger systems. |
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Large Federally Qualified Health Centers: FQHC and FQHC look-alikes with 10+ licensed providers. Does not include hospital-owned community based health clinics. |
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Medium Ambulatory practices (10-49): Practices with 10-49 licensed providers (MD/DO/NP/PA) in a single legal entity regardless of number of sites, and not otherwise included in larger systems (i.e. not employed or owned by a hospital or health system). Category does not include federally qualified health centers (FQHCs) or FQHC look-alikes. |
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Tier 4 |
Small Behavioral health: Standalone mental health or counseling clinics with < 10 licensed providers and not included in larger systems. |
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Home Health: Home Health providers that are Non-Medicare/Medicaid certified agencies. Standalone as defined by Massachusetts state licensing and not included in larger systems. |
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Long Term Services and Supports (LTSS): Medical supports only. |
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Small Federally Qualified Health Centers: FQHC and FQHC look-alikes with < 10 licensed providers. Does not include hospital-owned community based health clinics. |
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Small Ambulatory practices (3-9): Practices with 3-9 licensed providers (MD/DO/NP/PA) in a single legal entity regardless of number of sites, and not otherwise included in larger systems (i.e. not employed or owned by a hospital or health system). Category does not include federally qualified health centers (FQHCs) or FQHC look-alikes. |
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Community Service Agency (CSA): Community-based youth and family organization contracted to provide care coordination and support services to MassHealth members. |
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CP or CSA management-only entity: Organization that provides management and/or administrative services to a CP or CSA but is not directly providing healthcare services, care coordination, or support services to patients. |
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Tier 5 |
Very Small Ambulatory practices (1-2): Practices with 1-2 licensed providers (MD/DO/NP/PA) in a single legal entity regardless of number of sites, and not otherwise included in larger systems (i.e. not employed or owned by a hospital or health system). Category does not include federally qualified health centers (FQHCs) or FQHC look-alikes. |