There’s a photo on my desk of my grandmother: “my ‘Nunny and me’” laughing hysterically. My wife has one of “her Momoo” (gram) and her in a car, sun in her hair, completely herself. Not a patient. Not a diagnosis. Not a member ID number in a claims system.
That photo along with another where I’m giving her a kiss has traveled with me through 25 years of healthcare leadership, through boardrooms and budget cycles, through quality turnarounds and AI deployments, through the kind of decisions that affect hundreds of thousands of people at once. It sits there to remind me of something the industry occasionally forgets: the person at the center of everything we do looks a lot like someone’s grandmother.
Most recently, I spent years as President of Medicare Products at UPMC Health Plan, overseeing 228,000+ members and a Medicare enterprise that eventually earned simultaneous 5-Star ratings across HMO, PPO, and SNP in record time for three consecutive years followed by four years of JD Power wins. I am proud of those numbers. But the metric I come back to most often isn’t Stars or operating income. It’s simpler than that.
Did we take care of people like they were our grandmothers?
The Gap Between Policy and Person
Medicare was designed to protect our most vulnerable population — older adults and people with disabilities who have earned every benefit they receive. The architecture of Medicare Advantage, Stars quality programs, risk adjustment, and Special Needs Plans represents decades of policy evolution aimed at getting care right.
And yet.
Anyone who has helped a parent or grandparent navigate their health plan, find a specialist, understand an EOB, or appeal a denial knows the distance between policy intent and lived experience can be enormous. The friction is real. The confusion is real. The fear — especially when you’re elderly, possibly alone, and your health is what’s on the line — is real.
This is the gap I think about constantly. Not as an abstraction, but as a leadership problem with human consequences.
What “Grandma-Centered” Actually Means
I’m not suggesting we sentimentalize healthcare — there’s nothing soft about the rigor required to run a high-performing Medicare enterprise. Turnarounds, quality strategy, risk adjustment, AI-enabled clinical platforms — these are hard, technical, demanding disciplines.
But rigor and humanity aren’t opposites. They’re better together.
When I led the quality transformation at UPMC for Life, we built from a below-average baseline to 5-Star performance in record time. That didn’t happen because we got tougher on compliance metrics. It happened because we asked different questions — about what our members actually experienced, where the care gaps were in their real lives, and how our clinical teams and health plan operations could close those gaps together.
Grandma-centered care, in practice, looks like this:
Making the hard things simple. A Medicare member shouldn’t need a graduate degree to understand their benefits. When we design our communications, our portals, our workflows — we should be asking whether Nunny can navigate this on a Tuesday afternoon when she’s already overwhelmed.
Seeing the whole person. Risk adjustment exists for a reason: members with more complex needs require more resources. But the spirit of that policy is to actually address complexity, not just code for it. Special Needs Plans, LTSS integration, dual-eligible programs — these exist because some of our most vulnerable members have needs that cross every system at once. The question is whether we show up accordingly.
Getting to people before they fall through the cracks. Population health strategy isn’t a reporting exercise. It’s the work of identifying who needs us before they end up in an emergency room. AI-enabled care platforms, predictive analytics, and proactive outreach aren’t just operational efficiency plays — they are how we reach the grandmother who hasn’t seen her PCP in two years, who hasn’t filled her prescription, who is quietly declining in a way the system won’t notice until a crisis lands her in an inpatient bed.
Holding leaders accountable to the mission. Every quality program, every Star measure, every CMS audit exists in service of real people receiving real care. When I build leadership teams, I look for people who can hold both things at once — the discipline of metrics and the purpose behind them.
The Business Case Is Also Real
I want to be direct about something: grandma-centered care is not charity. It is strategy.
Health plans and healthcare organizations that truly commit to member experience — not as a marketing message but as an operational discipline — outperform. They retain members. They earn Stars. They control costs by getting ahead of utilization rather than reacting to it. They build the kind of trust that is genuinely hard to replicate.
In my experience, the organizations that struggle most are those that have lost the thread between their people and their purpose. When the only question on the table is “how do we hit the number,” you eventually stop asking whether the number is actually helping anyone. And that’s when performance starts to slip.
The multi-million dollar turnarounds I’ve led were built on accountability, rigor, and clear strategic vision — but it was also built on a shared sense that we were there to take care of people who were counting on us. That clarity of purpose is not incidental to performance. It is the foundation of it.
What I’m Carrying Forward
I founded Perri Solutions LLC because I believe that the hardest healthcare problems — the quality gaps, the strategic pivots, the organizational transformations — are solvable. I’ve seen it happen. I’ve led it.
But I also know that solving them requires leadership that keeps one hand on the data and one hand on the humanity. That holds strategy and purpose together without letting either one drift.
My grandmother didn’t know anything about Medicare Stars or risk adjustment or AI clinical platforms. But she knew whether she was being cared for. She knew whether the people around her saw her.
Every member in every plan we’ve ever built deserves to be seen the same way.
That’s what grandma-centered care means to me. And that’s the standard I bring to every engagement.