Delivering uncommon care® to our members in California

An interview with Kristen Slater,
Director of Clinical Operations, CCA Health California

How will CCA implement its innovative uncommon care model as it serves its members in California?

CCA’s uncommon care model was designed to support the medical, behavioral health, and social support needs of our members. Across the country we leverage our own care teams and partner closely with our provider networks to deliver and coordinate exceptional care focused on long-term health and wellness. This will be just as critical for our California members. By collaborating closely with our Independent Physician Associations (IPAs), CCA Health California will ensure that each and every member in our care receives the support they need to live safely and independently at home.

Today, our IPA partners deliver exceptional clinical support to our members, ensuring effective transitions of care when members are hospitalized or visit the Emergency Department.

As we begin to launch our uncommon care model, CCA Health California will serve as a strong and reliable partner, helping our IPAs support their patients recovering from these adverse events.

To ensure longer-term support, CCA Health California will also begin assessing and evaluating our members’ behavioral health and social support needs, coordinating comprehensive and longer-term support for those with more complex needs. 

What are some of the biggest healthcare barriers facing our members in California?

California is the most populated state in the U.S., with an incredible mix of diverse ethnicities, beliefs, values, countries of origin, and languages. This melting pot of cultures can sometimes make it difficult to deliver standardized healthcare services and programs, especially without a clear understanding of how each community makes decisions about care. Assessing the dynamics around family-decision making, views on Western Medicine, and similar cultural factors will be critical to delivering optimal care to our members in California. 

The two counties that we serve today are also different. In San Joaquin, a rural and agricultural county, many of our members battle isolation and may have to travel greater distances for physical and mental health services and for basic necessities, such as food. These members may also face unique environmental factors, such as groundwater contamination, air pollution, and Valley Fever, which is an infection caused by a fungus found in agricultural settings.

In nearby Santa Clara County, our members also face social isolation, which was exacerbated by the COVID-19 pandemic. However, individuals in this county may also face steep food and housing insecurity challenges. Living in one of the most expensive areas in the country—Silicon Valley—our members may struggle with basic necessities, especially as the country faces high inflation in the coming months and years.

As we continue to serve our members in these two counties, our primary goal will be to better meet the needs of each individual member, as well as their families, caretakers, and communities.

How is CCA Health California different from other health plans in the state?

California’s healthcare market includes a significant number of health plans, many of which are focused on delivering member-centric care that addresses each individual’s unique medical needs. CCA Health California takes this approach several steps further. First, we work to close gaps in care by addressing our members’ behavioral health and social support needs. Beyond looking at diagnoses on a claim, it’s critical that we understand the barriers to care that may impact our members longer-term. For instance, members of certain cultures may have deep-rooted distrust and fear of healthcare services. They may believe that going to see a doctor could lead to health issues. Understanding and addressing these beliefs will allow our team to personalize our engagement. Similarly, behavioral health stigmas are stronger in some cultures than others. Many members may view a mental health diagnosis as a sign of weakness and something that may bring about shame to the family. Understanding these beliefs will also be critical.

Second, we will focus on better understanding our members’ communities, including the local and regional factors that may impact their health. As I mentioned earlier, Valley Fever is unique to San Joaquin County. For members who are immunocompromised, this infection may lead to severe weight loss, pneumonia, meningitis, or even death. By understanding these risk factors, we can help our members overcome some of these serious and potentially life-altering complications.

What will be the first steps in launching our uncommon care model in the state?

Strong and seamless collaboration with our IPA partners will be critical to ensuring we can deliver uncommon care in California. We’re already on our way to increasing collaboration with our providers by working closely to better understand the medical, behavioral health, and social support needs of our members. Our goal is to support our IPAs in their efforts to manage those with complex needs. By coordinating outreach and engagement, CCA Health California will be working to identify these needs more proactively—before they can spiral into adverse events.

In 2023, we will also be launching an updated and more comprehensive HRA in order to give our members the opportunity to share their unique needs. These insights will help us create proactive care plans for each individual and determine the level of support needed to help each and every member stay healthy and live well.  

Tell us more about you.

Helping people is a passion of mine. As a trained social worker, I’ve spent my career helping individuals in difficult situation—and that’s what keeps me motivated. I’ve worked with people from all walks of life. Some of my previous roles included working for a rape crisis center, for an emergency child welfare organization, and I even had a private practice focused on trauma and substance use disorders.

I look forward to bringing my experience to CCA Health California, helping our members get access to the full range of care services they need.