State chief information officers (CIOs) will have to work together as states implement their new responsibilities under the Patient Protection and Affordable Care Act (PPACA), according to a publication released Thursday by the Lexington, Ky.-based National Association of State Chief Information Officers (NASCIO). While states have received some federal grant money, much will be expected in return, according to NASCIO's "On the Fence: IT Implications of the Health Benefit Exchanges."

The health benefit exchanges are intended to create market competition that drives down premiums, according to "On the Fence." States will either develop and run their own exchanges or default to the federal government to establish and operate the exchanges. The report details the legal requirements state CIOs will have to help meet in helping set up the exchanges.

PPACA provided $2.8 billion in initial funding to states to build benefit exchanges, expand Medicaid eligibility and continue prevention efforts, and states will receive billions more during 2011 and beyond. However, along with that funding comes the expectation for significant systems development to comply with federal mandates and within fairly rapid timelines, according to NASCIO. "Given the short timeframe for implementation of the Health Benefit Exchanges, it is critical that state CIOs work together to share expertise and explore shared solutions to maximize efficiencies and minimize costs," Lisa Feldner, North Dakota chief information officer and co-chair for the NASCIO Healthcare Working Group, said in a statement.

Download "On the Fence."