The framework

Free framework · from the operators behind Appius

The NEMT Scaling Framework

An operating system for a calm, profitable, sellable NEMT company.

Start with 01 VisionGet the PDF
Trips inPlanthe dayRunthe dayGet paidWHERE YOU'RE DRIVINGVisionPeopleFleet &toolsRelation-shipsScoreboard

Six components, one chapter each.

  1. 01VisionSet the three numbers
  2. 02PeopleWrite an SOP for every position
  3. 03The daily loopPut a clock on the loop
  4. 04Fleet and toolsCost per mile, and what it buys
  5. 05RelationshipsWhich accounts actually pay you
  6. 06ScoreboardRun the weekly review

In most NEMT companies the limit on growth is the owner. One person holds the schedule, the maintenance and the margin, and the company moves only as fast as they can. This framework breaks that job into six components. Each one repeats on a clock and has an owner other than you.

Each chapter
One component, taught in full — what it is, what it looks like when nobody owns it, and how to hand it over.
Each sheet
A two-page worksheet at the end of the chapter. Fill it in, put it on a wall. PDF, no email required.
Each quarter
Pick the component nobody owns, work through it, hand it over. One at a time is the whole method.

The ladder: Chaos to Sellable

Every NEMT company sits on one of these stages.

  1. 1Chaosthe owner is the system
  2. 2Controlthe loop is written down
  3. 3Calmthe team runs the loop
  4. 4Sellablea buyer could take the keys

You climb one stage at a time, and you climb by fixing components. Find the one nobody owns, spend a quarter on it, and hand it over. That's the whole method.

Before the ladder: when cash is short

The ladder assumes you have a quarter to spend on a component. If the bank balance will not cover payroll a few weeks from now, you do not, and the order changes. Do these first, in this order.

  1. 01Find every dollar that leavesBank and card statements, line by line, for the last three months. Anything nobody can explain stops until someone can.
  2. 02Collect what you are owedCall every account with an open balance. Move facilities to weekly payment from a card or bank account on file for the trips ahead.
  3. 03Check driver pay against tripsEach driver’s pay against the trips and hours they ran. A gap nobody can explain is often the largest leak in the company.
  4. 04Talk to lenders before a missed paymentA deferral asked for early is a conversation. Asked for after a missed payment, it is much harder to get.
  5. 05Arrange a bridgeMoney you are already owed for trips you have run is the strongest thing you can borrow against.

Then put the cash line on your Scoreboard so the next shortfall shows up thirteen weeks ahead, and start climbing.

The operating rhythm

Four cadences, zooming out from the day in front of you to the quarter ahead. None of them are long meetings.

Daily

365×/yr

The loop that runs the business.

  • Trips in
  • Plan the day
  • Run the day
  • Get paid

Weekly

52×/yr

One scoreboard, thirty minutes.

  • Scoreboard review
  • The seven numbers
  • Cash, thirteen weeks out

Monthly

12×/yr

Check the machine still runs.

  • Fleet check
  • A/R and payments by account
  • Recruiting pipeline

Quarterly

4×/yr

Step back and steer.

  • Per-account profitability
  • Compliance calendar sweep
  • Vision check

Where software fits

You don't need software to run this. A whiteboard and a steady weekly rhythm carry the framework fine. But three of the six components belong in a system: the daily loop, the scoreboard, and the billing tail behind every trip.

That's the part we built. Appius lays out the day, reworks it when the 9am cancellations hit, and turns every finished trip into a clean claim and a live per-trip margin. The framework is free either way. Appius just keeps the loop and the scoreboard running when you step out of the room.

Whatever you run today, test it with one trip. Follow it from the moment it arrives to the moment it is billed, and count every time someone types something the system already had. Each retype is a place an error gets in, and those errors come back weeks later as denied claims or disputed invoices, after much of the time to fix them has gone.

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