Beacon Communities share a year of experience
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Catherine J. Bruno, chief information officer of Eastern Maine Health Systems, cited the efforts of Maine’s Bangor Beacon Community to use active care management to improve the lives of people with chronic conditions, including diabetes and chronic obstructive pulmonary disease. “We accomplish this using care management every day and robust EMRs connected through HealthInfoNet [Maine’s health information exchange],” Bruno said.
“It takes willingness to work together on an ongoing basis, to coordinate care where it’s needed most. …We will measure the results, the improvements in patient care and take those data to payors to support our discussions about changing the way we are paid for care.”
The Bangor Beacon Community is seeking to get its community engaged and is building a system that is responsive to patient needs across the continuum of care, she said.
HealthBridge, a Beacon Community serving Greater Cincinnati, has implemented shared IT infrastructure at the community level, said Robert Steffel, president and CEO at HealthBridge. “We’re trying to evolve a fragmented community into a system that is more reliable and is patient-centered,” he said.
The HealthBridge Beacon Community is working to improve care management for patients with diabetes—including measuring reductions in ED visits and readmission rates—and is trying to use a community registry to develop performance feedback for optimal diabetes care. HealthBridge is also connecting with Cincinnati Children’s Hospital’s asthma collaborative, and working to move 20 practices to an advanced patient-centered medical home care model, “but workflow and process changes are needed to make this happen,” Steffel said.
"We would like people to get [to the point where] they end up competing with the data, not for the data,” he said.
“Sustainability is integrated into who we are. It’s the social costs—engineering and engagement—that are the hard part,” said Christopher G. Chute, MD, DrPH, of the Southeastern Minnesota Beacon Community. The Beacon has provided a "superb platform" for HIE and just-in-time delivery of data for patients and providers, Chute said.
The Southeastern Minnesota Beacon Community is working on a patient data repository to gather information that must be coordinated and organized “to provide better, cheaper, faster [information], with more security. … The major deliverable is population-based healthcare.”
Forty-seven school districts are participating in a Southeastern Minnesota Beacon Community project to manage asthma in children. Four-hundred children have asthma action plans today, and documents summarize appropriate interventions for each patient. “It’s maintained and up-to-date, so schools can see what care needs to be delivered," Chute said.
“We think of the KeyStone Beacon Community grant as a small business loan,” said James H. Walker, MD, chief health information officer at Geisinger Health System. “The value proposition is that regardless of payment reform … the reality is that for the rest of our working lives, care providers will be responsible for delivering reportable quality care at far lower costs. We are field testing in a fragmented, competitive, open community the methods to help all community providers achieve those goals. That’s probably not possible in any other way.”
“I have been stunned by the fact that in a wide open community … every time we have care process design meetings, more people come," said Walker. "What they report is that there’s almost universal consensus and real will to design shared care processes. It’s team-executed care but patients are the CEO of the team.”
Being able to perform analytics early in the process is critical because this is unbelievably demanding work for healthcare teams, Walker said. Very capable people may join the teams, but some have difficulty understanding different kinds of customers and their needs. Beacon team members "must have the ability to create the thing while you’re flying the airplane," he said.
From a payor perspective, Crescent City Beacon Program (New Orleans) has made tremendous strides over the past year, said Sabrina Heltz, senior vice president of healthcare system quality for Blue Cross/Blue Shield of Louisiana. “We serve the state and have a vested interest in seeing the Beacon be successful. Our Beacon came together as a group of providers, but it needed a focus. That’s the value of having payors at the table early,” said Heltz.
“But it’s important to remember that somebody’s savings is somebody’s revenue,” she said. “It’s not easy to do from a provider or payor perspective."
The work of the Beacons can be leveraged by all health stakeholders, she said. “I strongly encourage you to get payors involved.”