Advice From the Innovators

This article appears in the June 2012 issue of HealthLeaders magazine.

Linda Bahrke,
Heartland Health

"One advantage we have is that Aetna is providing us with data that allows us to proactively identify those outliers who need help with becoming compliant, so we can reach out to those patients. The No. 1 thing is data. We have a common EMR between all of our areas in our IDS. That's critical. It's very hard to coordinate care when you don't have the full picture of the patient, and it's really hard to manage care. Claims data that's coming from the insurer really helps paint the picture of the patient's care, but it's not complete without the available data from the EMR. An IDS that doesn't have a common EMR is going to struggle. It's so hard to analyze the care that's been given and learn and draw conclusions. No. 2, you have to have the relationships with nonsystem providers such that they also understand that value comes from high quality and low costs. If you don't have home care or long-term care business, for example, find some that believe in it as much as you do who are willing to share data to improve processes as well. Becoming a NCQA-recognized patient-centered medical home really helped us transform the mentality to care coordination from fee-for-service at the primary care setting."