Crossing Silos….. Deliberately #1

Policy folks, operators and advocates often lament silos as barriers to aging in place, good medical care and  other current issues. I agree, but I see very little effort that crosses silos. If silos are the problem, why not set strategies that cross silos deliberately? I hear about models and programs in caregiving, transportation, home modifications, technology senior centers and others.   Of course, providers acknowledge that no program exists as an island but I have not seen anyone take the ‘portfolio’ to break the silos. Is it sacred ground? Can we focus on breaking down silos? Will that get the job done? We can’t know if we don’t try.

Analogous action occurs in the business world all the time. Companies are horizontal…concentrating on their core, but see efficiencies by increasing control of related sectors so they take steps to be more vertical. Or, just as often, they see distractions and inefficiencies of their verticality and slough off divisions to improve operations. Oil companies are a good example. There are many segments involved in getting gas to the pump or the generating plant. Oil futures and exploration, extracting, shipping, refining, shipping again and retail. We often hear one of the big (or small) companies is reforming their parts to make things better. They buy a new division or sell one…all in the effort to get the mix of relationships right. Google does it. They build some parts in house, buy some and partner for others. Critics recognize how rarely acquisitions result in the predicted synergies. Daimler bought Chrysler and sloughed it off a few years later at a huge loss. Now Fiat is taking their chance with Chrysler.  Think Time-Warner and AOL. This month Time Warner ‘spun off’ Time, Inc into a separate company. Humana is at the cutting edge of in home care strategies..they have acquired some pieces including Senior Bridge but developed HumanaCares in-house.

Aging in Place 2.0…the organized  systematic future of Home and Community Bases Service needs this sort of businesslike thinking. Words like horizontal and vertical are not o.t We are stuck myopically in silos. We need n in the HCBS discussion. We need at least this sot of innovation to move deliberately to integration and collaboration in the future.