Objectives: In the US, the federal and state governments are supporting interoperable health information technology and health information exchange through policy interventions and financial investments. However, private healthcare organizations and partnerships have also been active in establishing exchange activities, promoting interoperability, and developing technologies. This combination of influence from different actors has resulted in a rapidly changing healthcare environment. In this context, we sought insights into the optimal roles for the public and private sectors in HIT/HIE policy development and implementation