Top 25 Innovators - 2020

Barr leads an accountable care organization that’s focused on supporting rural providers—24,000 clinicians and 250 community hospitals—and has also been a key figure in advancing the ACO concept across all rural settings. She was influential in helping shape a CMS program that offers interest-free loans to safety net providers. Those ACOs in turn generated enough savings in two years to pay back $37 million of the $96 million in loans. She also helped launch the National Rural Accountable Care Consortium so rural providers could participate in alternative pay models. At Caravan, its ACOs in Q4 of 2019 exceeded 15 of 20 benchmarks, with $237 in savings per member per year for a total of $135 million in savings. And in 2020, she oversaw the launch of a program to take on 100% of the downside risk for rural ACOs that otherwise wouldn’t join the program.

How do you identify opportunities for innovation?
I love looking for disagreement about how to solve a problem, particularly data that shows two sharply different perspectives. When you truly try to understand both sides you frequently find an innovative solution that neither side can see because they are defending their position.

What advice do you have for people who know how to get an idea in front of managers but may be afraid of failing?
Nothing works better than helping people understand the problem before you propose a solution. Almost everyone gets to the same place eventually, but entrepreneurs get there faster. If management has time to marinate on the problem they frequently come up with the same solution and the path to acceptance is much easier.

How do you stay focused on innovation during a crisis?
Opportunities that were ripe for innovation pre-COVID may no longer be a priority. Understand what the environment demands from innovation today and address immediate needs that build toward longer term strategies. Right now, financial sustainability is king. Once the public health emergency passes, it will be back to population health and value-based care. You have to create short-term profit to get traction on more strategic work.