The Beacon Community Program is part of a larger federal strategy to use health information technology (IT) as an enabling foundation for improving the nation’s health care system (1). It was funded by the Health Information Technology for Economic and Clinical Health Act under the American Recovery and Reinvestment Act, which also provided significant funding to drive adoption and “meaningful use” of electronic health records (EHRs) (2,3). Beacon Communities were encouraged to draw not only from health IT innovations, but also from other spheres, including quality improvement, payment reform, and consumer engagement (4,5). Thus, the focus in the Cincinnati, Ohio, Beacon Community was not only on technology, but also on the implementation of innovative strategies to transform care and improve outcomes. The Cincinnati program used the infrastructure of the Patient-Centered Medical Home (PCMH) model as a guide to realize the benefits of meaningful use (2,6), improve clinical outcomes, and redesign practice interactions and workflows (7). Similar to other Beacon Communities, Cincinnati targeted type 2 diabetes for its improvement efforts (8). Specific aims included increasing the proportion of people with diabetes in compliance with the “D5,” a National Quality Forum–endorsed composite measure indicative of diabetes control. The composite goals include an A1C <8%, blood pressure <140/90 mmHg, LDL cholesterol <100 mg/dL, 1 aspirin per day as appropriate, and self-reported nonsmoking status. Adherence requires all five goals to be met (9,10). Although project faculty enlisted basic improvement science methods that could be expanded to support work on any disease or condition, in this case, the interventions were tailored specifically to diabetes. Additionally, the project enlisted the PCMH framework as a marker of successful clinical and operational redesign and set a goal of 100% of practices recognized at a rating of Level 2 …