Adviser LeadingAge New York Summer 2015 July 2015 | Page 20

Feature
The Creative Destruction of
Long Term Care

T

here are very few industries more in flux than
long term care and it is now experiencing
a phenomenon that economists call creative
destruction. Simply, creative destruction is when a
new creative model of delivering services destroys
the old and, to be defined as creative destruction,
there must be a positive net effect. In the long
term care industry it could ultimately be defined
as happier recipients of care, with better quality
of life and whose care produces a smaller burden
on taxpayers. Creative destruction by definition also creates new problems with the
assumption that the new problems are less burdensome than the old.
National MedTrans Network (NMN) and partners are no strangers to the problems
created by New York’s Managed Long Term Care (MLTC) and Fully Integrated Dual
Advantage (FIDA) programs. NMN currently manages the transportation benefits of
approximately 30 percent of the MLTC beneficiaries in New York State. The logistics of
managing transportation are complex and when providing high-quality, safe service to
an aged and disabled population, the equation becomes infinitely more complex. For
example, the transportation service is often to medical appointments that can result in
life threatening consequences if missed.

The creative destruction of MLTC has new and very complicated associated problems
so it is vital that all stakeholders work together in finding solutions to ensure the health
and well-being of the people served. In delivering a service such as non-emergency
medical transportation, NMN, is willing to experiment if it will improve the service
delivered to customers. The improvement will be measured and evaluated so that ideas
that don’t yield measurable results are discontinued to ensure
resources are being used effectively. Following a process that
E-Mods . . . are simply home modifications
continuously delivers poor results is not acceptable. Even if 98
percent of ideas are not successful, there remain two percent
designed to increase safety and accessibility,
of ideas that have produced real solutions to real problems.
particularly in preventing falls.
The path to total quality improvement will be fraught with
complications, but the greatest failure is not trying.
A great example of this from NMN is the logistically agonizing
and costly problem of two-man transports. “Two-man” simply describes the fact that
it takes at least two people to get the person out of their home for a non-emergency
medical transport. The liability for transportation vendors performing this type of trip
is substantial and the resources and coordination required for such transports creates
significant challenges. In addition, the lack of accessibility and mobility increases the
safety risks for staff and the person being transported.
After almost a year of sitting through a painful weekly meeting where two-man
problems were discussed, a viable idea was finally generated. After careful analysis of the
(See Creative Destruction on page 21)

19

Adviser a publication of LeadingAge New York | Summer 2015