The History of NEHEN

In the summer of 1997, while performing a feasibility study for a client interested in implementing EDI (electronic data interchange), Computer Science Corporation (CSC) recognized that an all-payer, all-provider solution would benefit not only its client, but New England patients and providers in general. CSC seized the initiative to propose a collaborative EDI adoption and implementation effort, and in early 1998 the proposal garnered strong interest among several industry-leading health plans and providers. As a result, competing organizations learned that administrative efficiencies are not competitive differentiators, and that they could work together to achieve a common and mutually beneficial goal. A series of meetings orchestrated by CSC led to the formation of NEHEN, and CSC has served as the Program Manager ever since.

NEHEN's founding members - CareGroup, Harvard Pilgrim Healthcare, Lifespan, Partners Healthcare, Tufts Health Plan - recognized early on the value of using standards to integrate administrative transactions by sharing development costs, avoiding transaction fees and eliminating the need for clearinghouses.

While HIPAA was the compelling event, the Massachusetts Health Data Consortium deserves credit for their role in generating a community-wide interest in healthcare EDI, and fostering the collaborative environment required to form NEHEN.

In the year 2000, NEHEN successfully implemented specialty care referral transaction and multiplied transaction volumes for eligibility verification. Participation in NEHEN expanded to include contract affiliates - service providers, vendors or agents representing payers or providers. This new model allowed independent physicians, who were not aligned with integrated delivery networks, to connect and derive full benefit from NEHEN.

In 2001, NEHEN's membership expanded based on its success in integrating electronic eligibility verification, referrals and claim status inquiry into members' core administrative processes.

In 2002, NEHEN prepared to use the network to meet the challenge of claims and remittance transactions.

By 2003, NEHEN’s mission had grown into the region’s cooperative approach to adopting standardized electronic transaction and code set processing required under the federal Health Insurance Portability and Accountability Act (HIPAA). Health plans and provider organizations in Massachusetts and Rhode Island complied with the law’s October 2003 deadline by collaborating on standardized ANSI X12 transactions through NEHEN

Separately, in May 2003, MA-SHARE (pronounced “mass share”) was established as a program of the Massachusetts Health Data Consortium. Backed by many of the organizations active in NEHEN, with new leadership, vision and support from Blue Cross Blue Shield of Massachusetts and the continued shared program management from CSC, MA-SHARE sought to do for clinical health information sharing what NEHEN and CSC did for administrative processes – namely, to design and deploy technology solutions that assemble, organize and distribute clinical information to a broad range of clinical settings in a secure, confidential manner.

Having developed separately, NEHEN and MA-SHARE merged in July 2009 both to leverage the existing shared program management from CSC and to take advantage of the overlap in membership and core technology needs.

Today, NEHEN is regarded as a successful example of health information exchange for its self-sustaining financial model, having operated continuously without governmental support since 1998. With connectivity to over a dozen payers, serving more than 55 hospitals and thousands of physician practices in Massachusetts and Rhode Island. NEHEN processes over 100 million transactions per year.

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