Mostashari: Beacons 'taught us'
The Beacon Communities proved that organizations can advocate changes to how healthcare is paid for by working with payers and providers, while improving quality and safety at the same time — lessons learned locally but applicable to the entire nation, said Farzad mostashari, MD, national coordinator for health IT. “These were the pillars of the Beacon Community activities, and they taught us,” Mostashari said. “They showed what we needed to do.”
Mostashari spoke May 22 during an online event titled The Beacon Community Experience: Illuminating the Path Forward. The idea was to assess how the 17 Beacon Communites had fared over the past three years. The 17 communities across the country were funded by ONC with $250 million to serve as models for changing healthcare. ONC named 15 communities at first, and added two later.
Changing large health plans' payment structure for a single community is one example of an idea that just didn’t make sense; another was the reality that getting data out of EHRs so caregivers can work as teams was just too hard in many cases.
“We needed national movement,” Mostashari said. “We needed national standards because the vendors couldn’t build something just for you.”
Mostashari announced the release of a learning guide for "Beacon Nation." ONC describes the guide as encompassing approaches, lessons learned and best practices of Beacon Communities in implementing automated alerts triggered by admission, discharge and transfer events, all with the goal of helping communities improve chronic disease care and reduce readmissions.
[See also: Site visit: Hawaii's Beacon Community.]
“When we look back over the last three years, we’ve accelerated many of the objectives – lot of the vision we had in mind when we started our work," said Patrick Gordon, director of government programs at Rocky Mountain Health Plans and the program director of Colorado Beacon Consortium. "A lot of times it’s easy to just be consumed by the challenges and the next generation of work ahead of us. But, really, the learnings, the experiences, the networking and the trust fabric that’s been built over the last three years is incredible,” “And I do believe that those kinds of experiences are universal … and certainly not limited to any particular community.”
Also speaking at the event, Mark McClellan, MD, director of the Engelberg Center for Health Care Reform, a senior fellow at Brookings Institution, and a former CMS administrator said that “while we’re not there yet, we are making some important and visible progress in getting the goals aligned: better care, lower costs, better outcomes, through community action, through action at the practice level and to align financing. The Beacon program touched on all of these. We hope to move them all forward together.”
Both Mostashari and Gordon said it’s not just about the IT; rather, the people are the most important factor.
“The key to moving forward is just a willingness to start and take on the issues that we, ourselves, could handle and you don’t need tremendously sophisticated technology. You don’t need multi-million dollar grants,” Gordon said. “You need the will to move forward on a set of objectives and to recognize the process of change and moving forward will be continual. So at the end of the day that’s what we will continue doing as our project in Beacon comes to a close.”
Indeed, the Beacon experience is no longer about those 17 communities, Mostashari said. Payment changes and IT infrastructure implementation combined are turning the tide such that we can think about how to succeed, how to manage population health, how to change practice habits and figure out what to compete on and what to collaborate on.
Rather than competing on who can effectively hoard the most patient data, it serves everyone’s interest to figure out a business model for sharing it, he added, using the idea of taking even a small piece of patient data and transforming that into a service to sell to people who have a solid business reason to buy it.
“We took each of those challenges that the Beacons illuminated and the Beacons lived through and we made it a part of our mission, nationally, to try to improve. And, boy, was it hard, but despite that, the Beacons have all improved quality and safety in their communities,” Mostashari said. “Those lessons are relevant to a lot more people who are trying to navigate this transformation of American healthcare that is more fundamental, more profound, more exciting than anything we have seen in five decades past.”