It is generally believed that Health Information Exchanges (HIEs) improve healthcare delivery by reducing medical errors and administrative costs. The potential benefits of HIEs together with the possible risks (such as health information privacy and security concerns) are crucial factors to healthcare consumers' opt-in intentions toward HIEs. To maximize the full value of HIEs, it is important to accurately investigate healthcare consumers' beliefs and perceptions about the widespread implementation of HIEs. To do so, we conducted an online survey in the United States using a sample with 683 data points. Drawing on the utility theory, we have found that the perceived benefits and perceived risks associated with HIEs significantly influence perceived value, which in turn increases consumers' opt-in decisions. The results indicate that perceived benefits seem to have a greater impact on perceived value than perceived risk. Moreover, perceived value fully mediates the relationships of perceived benefits and perceived risk with consumer opt-in intentions to HIEs. The findings also highlight that consumers' attitudes toward HIE models, the perceived trustworthiness of healthcare entities, the perceived health information sensitivity, and the perceived health status significantly influence the perceived risk of HIE efforts. This study contributes to both research and practice and provides directions for future studies. (C) 2018 Elsevier Ltd. All rights reserved.