2 min read March 2023 — In an interview with Invest:, Nestor Plana, chairman and CEO of Independent Living Systems, talked about the challenges that the healthcare industry is facing, why South Florida specifically is an attractive place to be and how telemedicine is going to be a bigger part of the medical industry going forward.
What specific considerations do you take into account when helping people age in place?
“Processes, people and technology” is a phrase that everybody uses and that’s what it all comes down to. For the last 20 years, we have been building a very specialized piece of technology through our E-care system, and then we hire folks who are able to provide these care management services. Every single patient that we have in our health plans has been assigned to a care manager. These care managers only manage anywhere between 60 and 80 patients, so it’s very intense, personal care management and care coordination as they coordinate all of the members’ medical services and all their social services as well.
The difference is that because of our contract with the Florida Agency for Healthcare Administration, we are able to provide home and community-based services, which helps our members “age in place” surrounded by family, friends and loved ones. These services include things such as home delivered meals, diapers, adult day care services and personal care — things that are normally not covered by Medicare. We have home healthcare personnel that we send to a member’s home to bathe the patient, and take care of the patient in their home. If the patient lives in an assisted living facility, we work with the assisted living facility to provide services there so that the patient can continue to age in place.
We also work with nursing homes well since the life cycle of these patients continues to evolve. Our goal is to keep them in the community as long as possible because that’s really a win-win situation for everybody. Most families want to keep family members in their homes and in the community to be close to them. The state and the federal government also benefit with home and community-based services because the patient has better outcomes with less financial resources being spent.
We have a huge phenomenon in this country with the evolution of the aging population. Pharmaceutical companies and medical providers have done a great job at helping our seniors live longer and healthier lives. But, we need to help our seniors find alternatives to nursing homes if they don’t need that level of care just yet. This doesn’t mean that there’s no need for nursing homes, but the idea is to be able to help folks age in place as long as possible depending on the level of care they need.
What is the state of the industry given the labor disruption and affordability concerns?
There are several challenges. We live in the best state in the country – both for business and personal reasons – so we see more and more people moving into Florida, which is going to create some friction and some stress because those people are going to need additional services of this caliber. On the Medicaid side, these services are extremely expensive and are funded by the state and federal governments. Now, the waiting lists for people to get into these programs continues to grow and grow. We have about 4.5 million people in the state of Florida that received Medicaid surrogacy, but we only have 125,000 that are receiving long-term care services. We have a waiting list of over 50,000 people trying to get into the system, so the system is stressed. That’s why there is a critical need for home and community based services – these services are not an entitlement in the same way care in a more acute setting is.
Governor DeSantis has really done an amazing job by increasing the minimum wage by a significant amount for the healthcare workers that are providing services to the Medicaid population. However, this has led to the providers being stressed on the financial side with the salary increases. The other piece is that there is a shortage of personnel because a lot of care professionals are moving into other industries in the wake of the pandemic. We have a challenge trying to find the right personnel.
What role do you think telemedicine has in the industry?
Telemedicine is here to stay. It’s a very interesting subject because it was accelerated by 15 or 20 years because of COVID. During COVID, insurance companies figured out they could provide greater access and better quality of care by providing telemedicine. After all, you don’t always need to go to a doctor’s office, which means telemedicine can close this gap and improve the system by reducing capacity and wait times. It also means patients can be seen a lot faster and ailments are likely to be diagnosed much earlier.
Ultimately, the healthcare industry is working toward a convenience model, and there is no better example than the entry of Amazon into the space. Now that it has acquired the pharmacy, the next goal for these seniors is to be able to order treatment through Alexa or another system. We are going to see more and more of that evolution.
At the end of the day, we still have to touch the patient and undertake the right logistics, but the technology is changing. There is already a tremendous number of systems that can be placed in the home and gather all sorts of data. This can improve the system, the hospitals and readmissions because you’re able to manage the patient closer.
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