Evaluation of the Beacon Community of the Inland Northwest

The Beacon Community of the Inland Northwest (BCIN), a Beacon Community Program site based in the Spokane region, focuses on health information technology (HIT) through a health information exchange (HIE) to assist providers across separate organizations to facilitate care coordination (CC) and improve care of adult patients with type 2 diabetes (DM2). We are evaluating the BCIN to determine whether HIE and CC will increase receipt of DM2-related preventive health services while reducing DM2-related emergency, inpatient and outpatient utilization and costs. Through a third-party data vendor, we obtained 2009 DM2 patient claims data for commercial and Medicare insurance populations in the Spokane Hospital Referral Region (HRR) and a control region from the neighboring non-Beacon Boise, Missoula, Portland, and Yakima HRRs, with claims data for 2010-2012 forthcoming. Our commercial 2009 data contained 3,872 and 4,430 patients from the Spokane HRR and control region, respectively. There were significant baseline differences (P<0.001) in total allowed payments (Spokane $12,384 vs. control $11,499, P=0.02), total allowed ER payments ($240 vs. $160), total allowed DM2 ER payments ($104 vs. $63), ER visits (0.40 vs. 0.31), DM2 ER visits (0.16 vs. 0.12), HbA1c test counts (1.38 vs. 1.14), nephrology test counts (1.08 vs. 0.82), and LDL test counts (1.16 vs. 0.92). There were no baseline differences in general and DM2 inpatient admissions or costs, general and DM2 lengths of stay, morbidity scores, or eye exams counts. Our first year of baseline data on diabetic patients in the Spokane and control regions suggests that significant differences already exist. Spokane DM2 patients receive more care than patients in nearby regions on several measures. The BCIN's improvements in the HIE and CC are expected to leverage two-way real-time HIE in order to reduce DM2-related healthcare cost and utilization in the Spokane HRR while allowing for comparisons to other HRRs.