The Kaiser Permanente Healthy Bones Program has used a systematic approach to address the osteoporosis/fracture care gaps. The article discusses the ten-step processes that utilize information technology and care managers to identify, risk stratify, treat, and then track our patients with care gaps. This program has led to 40+% reduction in the expected number of hip fractures in 2009 that we attribute to the increase in DXA screening followed by appropriate osteoporosis treatment.