New York moves to hub‑and‑spoke model and pays QEs to provide statewide encounter alerting

David Horrocks of the New York eHealth Collaborative (NICE) outlined New York’s transition from multiple regional HIEs toward a hub‑and‑spoke encounter gateway model that centralizes ADT collection and pushes data to Qualified Entities (QEs) that deliver alerts to subscribers. He said the state contracts with QEs to provide a statewide encounter alerting service for Medicaid organizations and other customers.

“We are paying those QEs to provide that service, especially to all the organizations that are in New York's Medicaid program,” Horrocks said, explaining that the hub reduces overhead, improves data quality and enables central monitoring. He noted the prior point‑to‑point attribution approach had lower overhead but more data‑quality issues when ADTs traversed regions. Horrocks reported about 80% nondeduplicated Medicaid panel coverage in the statewide system and set a goal of 45% of customers on the statewide solution by the end of March; he also said two QEs were selected roughly 13 months earlier and went live about 10 months ago.

Horrocks described consent and privacy safeguards: New York operates a consent registry (opt‑in) but permits basic treating‑provider alerts without additional consent. He emphasized that centralizing certain infrastructure allows the state to pay QEs to meet consistent quality standards and support public‑health reporting.