An interview with Linda Perkins, RN
Director of Clinical Operations, CCA Health Michigan
CCA’s uncommon care model has been wildly successful in its home state of Massachusetts, helping individuals with significant needs address a wide range of medical, behavioral health, and social support needs. This model will easily adapt in Michigan, where underserved populations face a multitude of barriers to care. While many health plans in the state provide care management services to high-risk members—a reactive approach that focuses on addressing immediate medical needs—CCA Health Michigan will cater to the needs of the broader population.
Our team will focus on proactive outreach, with the goal of anticipating needs before they turn into medical emergencies. We will aim to personalize engagement and develop a care plan for our members based on their unique needs.
While some of our members may need weekly support at home, others many simply need or want a once-a-year phone call. We will work closely with members—as well as their providers, caregivers, community organizations, and other stakeholders—to ensure appropriate coordinate of care.
In my 25 years career as a nurse, case manager, and healthcare program leader, I’ve seen a wide range of care models. CCA Health Michigan’s focus on proactive, patient-centered engagement is unique. Our team, small but mighty, will be working to identify needs that may impact health status in the future. Our goal will be to create a more personalized care plan even for those who appear to be healthier on paper. This approach will help ensure we can anticipate needs and aim to solve or address smaller problems before they become full-blown emergencies.
Our care partners are dedicated to the work they do. They’re knowledgeable, compassionate problem-solvers who are driven by a sense of purpose. We hire people who strongly align with the CCA Health Michigan mission of helping individuals with significant needs.
Most importantly, we work tirelessly to ensure our marginalized communities have equitable access to care. That means that sometimes we need to deploy more intensive coordination efforts, including educating our members on self-management techniques that can set them up for future success.
In providing uncommon care, we work to ensure that we help that member feel more comfortable, ask the right questions, and advocate for their needs, values, and preferences. To succeed, our care partners must go above and beyond for our members—and that takes passion, commitment, self-motivation, and accountability.
Often, our seniors fall through the cracks of the healthcare system. Even with health coverage, they face access barriers because they don’t have transportation, they don’t speak the language, they don’t trust the system, or they simply don’t understand their benefits or know their rights. Connecting members to community resources and making sure they know what benefits they have access to will be top-of-mind for our team. Educating members on how to self-manage and better navigate the healthcare system will also be important. This isn’t education that most people receive until they’re faced with a health crisis.
Siloed care is yet another barrier that our seniors face. For example, members with diabetes may struggle to manage their condition if they are also managing depression or if they’re struggling with food or housing insecurity. Our basic human needs will always take precedence and it’s our duty as care partners to help members get past these challenges. By using every resource at our disposable, implementing out-of-the-box ideas, and using proven motivational tactics, we aim to close critical gaps in care and help our members live well and thrive.
One of our care partners, Shannon, has been working with a member over the past year who had a very poor prognosis. She spent months in the intensive care unit and her family was told she likely wouldn’t live long. Fortunately she did survive, but she had to have some amputations. After she was discharged from the hospital, she was moved to a skilled nursing facility for long-term care because she was unable to walk or safely live at home. Shannon would check in on her frequently, helping the member get the care and support that she needed in order to improve, including connecting her with physical and occupation therapies and getting her the appropriate medical equipment.
Little by little, with Shannon’s support and care coordination efforts, this member began making meaningful progress. Soon, she was able to put on lotion, comb her hair, dress herself, walk to a bathroom with a walker, and do other daily activities that we often take for granted. This progress gave the member hope and helped her feel less depressed about her circumstances. Eventually, the member was able to move out of long-term care and now lives with her daughter. Shannon has continued to provide support, ensuring the member has all of the therapies and at-home equipment she needs. Shannon is also helping the member reach new goals, such as climb the stairs so she can sleep in her new bed that’s waiting for her in an upstairs bedroom.
This is just one of many stories that make our work truly rewarding. It’s inspiring to see our members overcome daily challenges and we’re grateful to play a small part in their story of long-term health and well-being.
Linda is Director of Clinical Operations for CCA Health Michigan. In this role, she is focused on ensuring we deliver the highest level of clinical coordination, working closely with our care partners to optimize quality outcomes and member experience. Linda is a Registered Nurse with extensive experience in developing, implementing, and delivering highly effective case management and care coordination programs.