When you look for a place to care for your aging mom or dad, you want a comfortable home and family environment that nurtures a sense of community. But this is getting increasingly difficult to find.
There is a massive transformation under way in the long-term healthcare industry. COVID-19 has been the most visible driver, with nursing homes accounting for a disproportionate number of deaths. But pressures and complexities in many dimensions, from demographic changes to soaring costs to aggressive consolidation, are straining the industry and risk harming patient care.
I believe there is a place for entrepreneurs and new innovations to help ease the burden and create a better environment to provide care. The long-term health care industry needs to move more quickly to adopt technology that will help them build a better, stronger, more resilient work force.
Time is running out. Our aging population, coupled with an increasing number of chronic conditions, is leading to a rising number of people who will need long-term care.
On the provider side, the challenge is even more acute. Nurses and other health workers chose careers that care for others, but even they cannot bear the burnout and trauma of a pandemic. Broader changes in workforce dynamics are also at play, as complaints about low pay, limited advancement, and feeling disrespected help drive the Great Resignation. Quit rates in health care are approaching one in five since the pandemic started. Quite frankly, it's easier to work in a lobby of a Ritz Carlton than it is to work in a Medicaid-funded, skilled nursing facility, doing less-than-glamorous jobs.
At the same time, families are finding that costs are soaring. The cost of long-term care reached an estimated $849 billion in 2018.
All these changes are driving consolidation. Private equity firms have been buying up facilities and rolling them into corporate holdings. As with any industry in a capitalist society, the underlying motive is to build lasting profit. Theoretically this is a good thing, as competition should drive quality and accountability. Yet businesses that are more about human interaction and less about scale, systems, and processes tend not to roll up very well.
Of all these issues, ultimately the most critical one is human capital. Nothing happens without the people caring for the residents and operating the systems. And if you don't take care of them first, nothing else matters. That’s why President Biden has announced reforms that include ensuring every nursing home provides a sufficient number of adequately trained staff to provide high-quality care. While the health care industry at-large is not unified on these government-initiated changes, it’s evidence that the human capital issue is broadly seen as the point of the spear of the complexities inside the delivery of quality health care.
The more an industry aims for economies of scale, the sharper and more thoughtful it must be with systems and processes. Yet health care has been incredibly slow to adopt technology, possibly because leaders historically come from medicine and not IT.
I don't think that the long-term care industry is prepared for the wave of demand they are going to see, the challenges in the labor market, and their relative inability from a systems and process perspective to manage it.
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