Date Range

December, 2015

Last Updated


Health IT State Policy Levers Compendium



The Health IT State Policy Levers Compendium was developed by the Office of National Coordinator for Health Information Technology (ONC) in coordination with states. It is intended to support state efforts to advance interoperability and can also be used in service of delivery system reform. The Compendium includes a directory of health IT policy levers and nearly 300 examples of how states have used them. The 'Activities Catalog' includes the over 300 documented examples of health IT policy levers in use by states. The catalog data includes the states using the policy lever to promote health IT and advance interoperability, the state's documented activities, and official information source for these activities.

*This data is API accessible. See /api for documentation and guidance on how to use the API.

Data Field Data Description Additional Information
policy_lever_description Description of Policy Lever // The description of the policy lever in general or official terms. This provides the information necessary to understand the policy lever and its applications at the state level.
activity_description Description of Policy Lever Activity // Documented and verified description of the state's use of the policy lever to promote health IT and/or advance interoperability.
policy_lever Health IT Policy Lever // A health IT policy lever can be defined as any form of incentive, penalty, or mandate used to effectuate change in support of health IT adoption, use, or interoperability. The policy levers categorized and catalogued in the Compendium are limited to those that employ joint federal-state authorities (i.e., Medicaid levers), state-level authorities, and private sector levers. State-level authorities generally mean state laws, state regulations, state funding, and state programs (again, outside of Medicaid) that direct the spending of state money on providing care or influencing it in some way. Private-sector levers are included to the extent they are implemented at a state level. Federal-level policies (e.g., Medicare levers) are considered out of scope for the Compendium.
source Information Source // The official source of the policy lever activity (Example Activities Catalog). The hyperlink for the source of the policy lever description (Policy Levers Directory).
source_url Information Source Hyperlink // The hyperlink for the source of the policy lever activity (Example Activities Catalog).
point_of_contact_email Point of Contact E-mail Address // The public e-mail address of ONC's collaborator in the listed state. This e-mail can be used to contact the state official directly.
point_of_contact_name Point of Contact Name // The name of ONC's collaborator in the listed state. The collaborator is a state official and often directly involved in the state's health IT programs and policies.
point_of_contact_title Point of Contact Official Title // The official title of ONC's collaborator in the listed state.
state State // The state in which the policy lever has a documented and verified use (Example Activities Catalog). Point of contact's state (State Points of Contact).
state_level_authority State Level Authority // Yes or No. This authority refers to policy authorities that rest primarily with the state, i.e. non-federal levers.
activity_status Status of Policy Lever Activity // Actual, Proposed, or Expired The policy lever activities may have a current status of 'actual', 'proposed', or 'expired'. A lever with an 'actual' status is in current use; a lever with a 'proposed' status is not in current use, but has been proposed at the state level; and, a lever with an 'expired' status no longer in use, it is a historic activity.
policy_lever_uses_health_IT_interoperability Uses of Policy Lever for Promotion of Health IT and Interoperability // The description of how the policy lever is or can be used to promote health IT and/or advance interoperability at the state level.

ONC collaborated with state officials to collect and validate the Compendium data. The data to construct the Compendium was originally derived from the following: ONC State HIE Program Strategic Operational Plan Updates submitted by states, public documents of Medicaid State Plan Amendments and 1115 Waivers, and ONC staff knowledge based on state interactions. All the state activities catalogued have been reviewed and validated by state government officials from the respective states.