2013 Up and Comers: Dr. Irene Krokos

Patty Kehoe, president of Molina Healthcare of New Mexico, says the first impressions she had of her Medicaid managed-care plan's chief medical officer, Dr. Irene Krokos, revolved around her creativity and the way she looked for opportunities to be innovative.

Krokos, who took over as CMO in May 2012, says it's the qualities of New Mexico—not the least of which include being large in area but small in population—that require her to be creative.

“Necessity is the mother of innovation, and we have a lot of need in this state,” she says, describing how New Mexico's small-but-diverse population is spread out over areas classified as urban, suburban, rural and frontier.

Krokos, 38, says when she speaks to friends and family back home in Michigan, they think they know all about “rural,” but “frontier” is an entirely different concept. “I don't think people can comprehend it,” she says, explaining how pictures of remote communities in the state such as Mexican Springs available on Google Maps usually offer the best illustration of the areas—where people, electricity and telephone service are hard to find.

Kehoe wouldn't be surprised that Krokos makes her point this way. She describes Krokos as being “very technologically literate,” with an ability to find new ways of presenting data and illustrating concepts.

As CMO, Krokos implemented a statewide medical-home program that was adopted by New Mexico's Medicaid agency and started the Care Transitions effort, which is initiated while patients are hospitalized and continues with in-home health coaching. The program has decreased hospitalizations and emergency department visits by making sure patients understand their prescriptions, have transportation to follow-up doctor appointments and receive any medical equipment necessary for home healthcare.

For her accomplishments, Krokos won a place in Modern Healthcare's 2013 class of Up and Comers.

Kehoe adds that when Krokos arrived at Molina as associate medical director in 2010, she had no background in insurance or managed care, having spent her early career practicing as a hospitalist. But Krokos says having that experience prepared her well for her new role because it combines patient care, quality improvement, examining resource utilization and studying how gaps in care result in readmissions.

“While I do miss the one-on-one interaction, it's rewarding to me to know that what we're doing takes on a bigger scale as a public health intervention,” Krokos says.

Kehoe praises Krokos' focus on continuous quality improvement, which requires winning over employees with long memories of past quality-improvement failures and whose reflexive response to new initiatives is, “We tried that before and it didn't work.”

“I try to find out the situation and ask why it didn't work,” Krokos says. “What if we did it this way? How do we make it work?” She says these instances remind her of a cartoon with two people looking at the same number with one seeing a six and the other seeing a nine. “How do we reconcile that perspective and get a 360-degree view of how we can make something better?” Krokos asks. “I tend to not to take 'No' for an answer.”