GT Independence Hires Growth Veteran to Scale Self-Directed Care Model

STURGIS, Mich. – August 31, 2026 – In a move that signals a significant strategic pivot towards aggressive national expansion, GT Independence has appointed healthcare growth veteran Chris Karkenny as its new chief executive officer. The announcement sees founder John Carmichael transition to a board role, entrusting the company’s next chapter to an executive with a formidable track record of scaling multi-site healthcare enterprises. This is more than a simple C-suite change; it's a calculated decision to install a proven growth engine into a mission-driven company poised to capitalize on the burgeoning self-directed care market.

For leaders and investors tracking operational innovation, the appointment is a classic case study in professionalizing growth. GT Independence, a leading financial management services (FMS) provider for individuals self-directing their long-term care, has built a substantial footprint, serving over 60,000 people in 21 states. Now, by bringing in Karkenny, the company is betting that a playbook honed in fast-paced sectors like ophthalmology and home healthcare can be the key to unlocking true national scale.

A Playbook for National Scale

To understand the strategic rationale behind hiring Karkenny, one must look at his extensive 25-year career, which reads like a blueprint for rapid expansion. Most recently, as CEO of NVISION Eye Centers since 2018, he presided over a period of explosive growth. Under his leadership, NVISION transformed into one of the nation's fastest-growing ophthalmology platforms, expanding from roughly 70 locations in 2022 to over 100 clinics and surgery centers by 2024 through a disciplined strategy of strategic acquisitions and partnerships.

This wasn't an isolated success. Karkenny's career is marked by his ability to lead organizations through periods of significant growth, often involving complex integrations. He has reportedly led or integrated over 30 acquisitions with an aggregate value exceeding $10 billion. At Apria Healthcare, a national firm with $2 billion in revenue, the company saw revenue growth of over 60% during his tenure as EVP and CFO. His leadership at companies like PacifiCare Health Systems and Coram Infusion Services is credited with creating over $8.5 billion in shareholder value.

This history is precisely why his appointment at GT Independence is so noteworthy. He is not a tenured expert in the niche FMS world but an expert in the process of growth. His experience lies in identifying market opportunities, executing acquisitions, integrating disparate operations, and building a scalable corporate infrastructure—skills that are directly transferable and highly valuable for a company looking to consolidate a fragmented market and expand its geographic reach. As Karkenny himself noted, he is excited to "build on GT Independence's strong foundation, expand its reach and help more people live their lives with greater choice and independence."

The Self-Direction Imperative

Karkenny joins a company operating at the heart of a fundamental shift in long-term care. The self-directed model, which empowers individuals with disabilities and older adults to manage their own care budgets and choose their own caregivers, is moving from a niche alternative to a mainstream preference. This trend is fueled by an aging population, a strong disability rights movement, and a clear policy preference from the Centers for Medicare & Medicaid Services (CMS) for Home and Community-Based Services (HCBS) over more costly institutional care.

While the promise of self-direction—greater autonomy, personalization, and often, better outcomes—is compelling, the reality is administratively complex. Individuals or their families become, in effect, small employers. They must navigate payroll, tax withholdings, worker's compensation, and state-specific compliance requirements. This is the critical gap that FMS providers like GT Independence fill. They act as the operational backbone, handling the financial and administrative burdens so that participants can focus on their care.

GT Independence has established itself as a national leader by effectively managing this complexity for state Medicaid agencies and managed care organizations. The company’s service is the "operational innovation" that makes the entire self-direction model viable at scale. By ensuring compliance and simplifying administration, they provide the trust and reliability that government payers require, and the support that participants need.

Balancing Mission with a Growth Mandate

The challenge for GT Independence will be executing an aggressive growth strategy without diluting the mission-centric culture that has been its hallmark. The company was founded by John Carmichael's family with the explicit goal of giving people "greater control over who provides their care and more independence." This is a deeply personal mission, and maintaining it during a phase of rapid, M&A-driven expansion is a delicate balancing act.

The leadership structure appears designed to manage this very tension. Carmichael's move to the board, coupled with his family retaining an ownership interest, ensures the founding vision remains a guiding force at the highest level of governance. "Chris has a deep appreciation for our mission and a clear vision for how GT Independence can further extend its impact," Carmichael stated, signaling his confidence in the transition.

Furthermore, the continued presence of President D. Pearl Barnett provides crucial operational and cultural continuity. Barnett’s emphasis on person-centered support is a grounding force. "His commitment to person-centered support aligns perfectly with GT Independence's mission and values," Barnett said of Karkenny, highlighting the effort to bridge the new growth mandate with the company's core identity. This structure—a growth-focused CEO, a mission-focused founder on the board, and a culture-bearing president in a key leadership role—is a deliberate attempt to get the best of both worlds.

Navigating a Fragmented Landscape

Looking ahead, Karkenny's primary task will be to navigate the fragmented and highly regulated landscape of long-term care in the U.S. FMS services are typically governed by state-specific Medicaid waiver programs, creating a patchwork of different rules, reimbursement rates, and operational requirements. A successful national expansion strategy cannot be one-size-fits-all.

This is where Karkenny's experience with integrating dozens of regional businesses into a cohesive national platform becomes paramount. GT Independence's growth will likely involve a combination of winning new state contracts and acquiring smaller, regional FMS providers. Karkenny’s playbook from NVISION—where he integrated practices across California, Arizona, Nevada, Oregon, and Texas—will be invaluable. The key will be to develop a standardized yet flexible operational model that can be efficiently deployed in new states while accommodating local regulatory nuances.

For GT Independence, the appointment of Chris Karkenny is a clear statement of intent. The company is moving to professionalize its growth, applying the disciplined strategies of high-growth healthcare sectors to the world of self-directed care. If successful, this new chapter will not only expand the company's footprint but also play a significant role in making independent, person-centered living a scalable reality for thousands more Americans.