The 17 Beacon Communities, stretching from Maine to Hawaii, are celebrating their first anniversary. While much progress has been made, it is clear that this is "a journey of quality improvement that never ends," as one expert put it.

The Engelberg Center for Health Care Reform at Brookings, in collaboration with the Office of the National Coordinator for Health IT, offered a one-year anniversary update on the Beacon Communities in Washington on Tuesday.

Mark B. McClellan, director, Engelberg Center for Health Care Reform, opened the Brooking's event. "The Beacon Communities strengthen the local capacity to achieve improvement in the way care is delivered," he said. Although McClellan recognized that the anniversary was about identifying the progress the communities had made in the short-term, he also said it was about looking at what lies ahead in terms of challenges, especially when it comes to questions about sustainability.

Aneesh Chopra (pictured at right), the United States chief technology officer, said that the Beacon communities represent the "test beds and innovation labs for a new world" that will have an emphasis on keeping people healthy. 

Chopra announced one such project that is being launched by the Centers for Disease Control, the North Carolina Beacon and Asthmapolis, a company that provides GPS inhaler and mobile phone applications for patients with asthma. The program will allow asthma patients to enroll in text messaging program that will follow them after discharge. Chopra said the program is about, "enrolling 2,000 folks in North Carolina in a program to harness new information that has not been collected in healthcare before."

CMS is also launching some new programs though its Innovation Center. The first, the Pioneer ONC Model, "invites experienced ACOs to join together and work at a rapid pace for higher level of share savings and higher level of risks," said Joseph McCannon, senior advisor to the administrator at CMS. If this is successful in the third year it would go to a population-based model, he said.

The second program, the Advanced Payment Program, is a "proposal to explore an advance on shared savings that would be expected as a function as part of the Medicaid Shared Savings Program," he said. Comments on the proposal are being accepted through June 17, McCannon added.

The third program, the Advanced Development Learning Sessions, will include four sessions that will begin on June 20 that will focus on preparing people for the accountable care experience."

"There is no longer any question that we will be moving to healthcare financing that rewards value over volume,"said ONC head Farzad Mostashari, MD.

But he stressed that, "it is not about the technology. It's about what we are going to do with the technology." In other words, he said, you can't just put a piano in the room and call it good. This is where the Beacon Communities come in. Mostashari says they represent jazz bands, and how we can all play beautifully together.
 
"We want to deliver care that is truly patient-centered," he said. "We welcome and yearn for the opportunity to not go broke in doing so. But it is going to be hard work."

The ONC represents an "angel investor and the Beacon communities are its start-ups," said Sherry Reynolds, executive director of Alliance4Health and part of the Beacon Community of the Inland Northwest. She said the Beacon leaders responsibility is to remember the voice of the patient. "The patient needs to be at the table during the design stage and driving engagement," she added.

The Colorado Beacon Consortium is aiming to do just that. Julie Schilz, its director, said that the consortium has begun to put patients on their quality improvement team. Currently they are working with 75 practices in seven counties to help them create their own communities.