I just read that Vermont has a quarterly tax on health plans to support their HIE efforts and RHIOs.  I' m not typically one for additional taxes, but this one seems like it will help address the accrual of benefits issue -- at least in Vermont. 

I' d also suggest that any payments or contributions to an HIE by a health plan could be a deduction from taxes.

My hope is that the health plans step forward and take a more active and engaged role in supporting HIEs in 2009.