Woman with COPD thankful for healthcare organization that helps her live safely and independently at home

Massachusetts resident Cynthia has been hospitalized many times for her COPD and asthma. She admittedly faces daily challenges. For example, just moving around the house can often be difficult. Following her hospital stays, she often found herself back home unable to manage her condition on her own.

When she heard about Commonwealth Care Alliance (CCA), a community-based, person-centered health plan, she decided to give them a try. CCA offers complex care coordination and delivery that is designed for individuals with significant medical, behavioral health and social support needs¹.

While living with COPD still has challenges, Cynthia reports positive changes to her life since receiving support from CCA’s team, which she says has helped her to take better control of her condition. She used to panic when she struggled with her breathing. Now, she says, “I don’t panic as much because of everything [CCA] taught me.”

Based in Boston, Mass., CCA, a national, multi-state healthcare organization that serves individuals in Massachusetts, Rhode Island and California, recently expanded to Michigan through a majority stake acquisition of Reliance Healthcare. As part of the acquisition, Reliance Healthcare, which serves nearly 20,000 individuals in southeast Michigan, will soon become CCA Health Michigan². Under its new name, the plan will continue to serve members in Genesee, Lapeer, Macomb, Monroe, Oakland, St. Clair and Wayne counties.

Soon Medicare and Medicaid eligible individuals in these counties will be introduced to CCA’s uncommon care® model, which is nationally recognized for improving quality and health outcomes, and aims to help people with multiple chronic conditions, disabilities and social needs live more independently in their own homes. The model prioritizes serving the unique health needs of members by providing an individualized approach to care and combating health disparities by addressing food and housing security, transportation, crisis support and more.

The CCA care model was developed after decades of innovation and is consistently recognized as one of the best in the country at supporting underserved individuals. The model will soon support CCA Health Michigan in delivering on its mission to address barriers to a healthier life and meet the demand for superior healthcare to the Michiganders who need it most.

Healthcare needs in Southeast Michigan

More than a third of Detroit’s residents are living in poverty with a median income of $29,481 in Detroit, compared with $54,938 for the state, according to the most recent U.S. Census data. Many of those individuals have pre-existing health conditions such as emphysema, heart disease, hypertension and COPD.

While only 8.7 percent of Detroit residents lack health insurance, according to a 2018 survey conducted by the University of Michigan’s Detroit Metro Area Communities Study (DMACS), many of those with insurance still face barriers to accessing the quality healthcare they need. That same study found that nearly 10 percent of Detroit residents report being unable to afford a copayment or prescription in the last 12 months, while another third report that they have been unable to access one or more types of desired healthcare in the past 12 months.

These barriers are even more evident among people without health insurance. Three out of every five Detroit residents without health insurance report being unable to access the healthcare they desire and nearly a quarter report being unable to afford care in the last 12 months. The survey also reveals important health inequalities within the city’s population related to racial and economic disparities. For example, the city’s Black residents and residents of a lower socio-economic status report lower levels of health than other residents and are significantly more likely to use emergency rooms as their primary place of care.

Improving access to healthcare for individuals with significant needs

Over 72 percent of CCA members have physical or mental health disabilities; over 66 percent have severe mental illness and 5.5 percent were documented as homeless at the time of enrollment³. Beyond helping with healthcare needs, CCA’s team makes sure members have enough food and a safe place to live. In fact, the CCA model includes an interprofessional team that collaborates to help coordinate members’ medical, behavioral health, and social support needs¹.  

This interprofessional team has been especially beneficial for Cynthia who over the years has been hospitalized often for COPD. In the past, she would just be sent home with no follow-up course of action. With CCA, follow-up care is standard practice. Now when Cynthia leaves the hospital, CCA’s team checks-in on her. They explain the steps she should take to manage her condition. For instance, she learned how to use a walker with wheels to sit down and breathe slowly when she struggles with her COPD. As Cynthia puts it, “CCA’s team taught me how to breathe. They never taught me that in the hospital.”

Cynthia learned about CCA’s uncommon care approach in an uncommon way: from another health plan. Three years ago, she called another health plan to inquire about enrolling. When the person on the phone learned Cynthia’s age and health condition, they suggested she sign up with CCA instead. Cynthia took the advice and hasn’t regretted it. She hopes others get the same benefit she did from the plan — which is why she is passionate about sharing her experience with CCA so others may receive the same care and attention to live safely and independently in their own homes and communities.

CCA Health Michigan will soon be available to individuals eligible for Medicare or those on Medicare and Medicaid in the state. To learn more, visit ccahealthmi.org.

¹For some plans, CCA offers support based on individual needs

²Pending regulatory approval

³CCA One Care members in Massachusetts