Time to look for solutions to funding aging services in new places
Jeff A. Petty
Jim Berklan's recently posted blog titled “Insurance, the elderly and what to do next” correctly cites just a few of the countless problems with how aging services are currently being funded. He goes on to conclude that the problem is far more complicated than it first appears.
I agree wholeheartedly with those sentiments, and would like to add a few observations:
1. The problem is both the funding and the service delivery models in aging services. Both are broken, and both need to be addressed in any real solution is to be implemented. If the service delivery system continues without fundamental change, then costs will continue to escalate unabated. In that scenario, any discussion of funding is just a shell game — neither the government nor private insurers create wealth. All of the money ultimately comes from the same source, us.
2. If we intend to solve these problems, we need to be willing to stop looking for the solution in the processes that created the problem. I call this the “iron lung strategy.”
I saw a recent study that estimated that, had we continued on the path we were on in the early 1950s, we would now be spending approximately $70 billion annually on dealing with the effects of polio. If we applied the thinking we are using now to address the challenges of aging services, we would have spent the last 60 years building a better iron lung and learning how to treat polio victims in less expensive settings — when the real solution was a vaccine.
As the story goes about totally committing all of your energy and focus on getting to the top of the mountain that you're on — only to find out that there is a taller mountain right across the next valley that you should have been on all along — we're trying to climb the wrong mountain.
We need to let go of the current models — the fix is not there. To paraphrase Henry Ford, he wasn't going to deliver a solution by breeding a faster horse. This requires something new.
3. As aging services providers, we are the only ones in a position to craft that solution. Yet we are at risk of letting others ignore our voice.
For example, policy makers see 50% of the Medicare dollar spent in acute care settings, and by applying Pareto's Principle, look there for the solution. But, of course, that's not where the senior is — hospitals don't, and can't, “control” seniors, nor does the senior's physician, who might see the senior every month or two for 15 minutes. Through our systems and communities, we see the senior numerous times every day. We know what is going on with them and what they need.
In an “all roads lead to Rome” analogy, whatever the ultimate solutions are to this coming tsunami, they must be centered around aging service providers. And we must be prepared to step up to that role and be heard.
4. We're going to have to be bold and we're going to need the long view. The recent challenge grants, sponsored by the Center for Medicare & Medicaid Innovation, demanded results from any applicant within six months. The center has an overwhelming charter and understandably needs to show quick improvements. Yet if the solution were that easy and quick, we probably would have done it a long time ago.
We need to be disciplined enough to look for real solutions and not just quick ones.
As Jim indicates, these problems are extraordinarily complex. Aging service providers ought to stand fast that we understand the issues before we start implementing responses.
Jeff Petty is the president and CEO of Wesley Enhanced Living (WEL), which he joined in 2003.
In 2003, Jeff Petty joined Wesley Enhanced Living (WEL) as the President and CEO in 2003. An industry leader with deep understanding of the economic challenges in the aging services industry, Petty has created WEL SHIFT (Wesley Enhanced Living's Senior Health and Housing Initiative for Transformation).