Strategizing for Growth & Innovation with Alaina Macia

Alaina Macia took MTM from $40 million to $500 million. As you read below, it’s easy to see how her focus on strategy and innovation have helped MTM focus on bold but practical goals and reach major milestones along the way. 



Your company, MTM, is over 20 years old. How have you deviated from your original plan? Has anything stayed the same since day 1?

Although we have stayed true to our original business plan to this day, that doesn’t mean there haven’t been modifications to our operating model. In response to areas of opportunity in the healthcare marketplace, we have introduced new products and new partner companies to help meet our clients’ needs. Overall, our vision has remained the same: communities without barriers.

Do you create goals for yourself or your team? How do you measure and define success and how far are you willing to go to succeed?

Absolutely – if you don’t have a goal and a strong, clear plan to achieve your goals, you don’t know where you are headed. As an organization, we establish audacious goals but also put in guardrails on what we will and won’t do – both new business and new projects. While we of course do everything in our power to succeed, most importantly we always stay true to our ethics in all we do. Reputation is everything.


“While we of course do everything in our power to succeed, most importantly we always stay true to our ethics in all we do. Reputation is everything.”

When you first started, where did you see your company headed? Where you see yourself and your business in 10 years? 20 years?

When we started, I thought we would hit our growth targets much easier. While we did eventually hit those targets, it took twice as long as I originally anticipated. Even so, we had explosive growth. In 10 years, I hope that we are at $1 billion in revenue; currently, we are at $500 million. While achieving this growth goal, I hope that our product base continues to diversify but stays close to our current product offering and core business.

How do you generate new ideas? How important is innovation in your business?

Our greatest ideas come from listening to what our clients want and need, using their input as a springboard for innovation. We also closely watch where the industry is heading. Innovation is key – if you aren’t evolving, you are dying.

Do you have some examples of tactics you use to look at the big picture and work “on” your business (vs. “in” your business)?

Strategic planning is key to ensuring everyone is aligned. This year, we are formalizing our strategic planning processes; we are interviewing all executives and directors and also conducting focus groups with our clients and vendors to ensure we keep the VOC (Voice of the Customer) in mind.


“Most importantly, you have to be brutally honest with yourself on whether something is going to succeed or not.”

How long do you stick with an idea before giving up? When do you know that it’s time to pivot? 

We see some strategies through for a year or more. It takes time to build a product and sell it to your clients. Sometimes that idea evolves and changes to be something the client is more interested in investing in. What is important is to ensure the level of effort and investment is commiserate with the future ROI and that you aren’t over investing for a return that will never materialize. Most importantly, you have to be brutally honest with yourself on whether something is going to succeed or not.

You started at MTM as an analyst and just two years later took over as President and CEO. How have you changed the company since then?

When I started, MTM was at $40 million in revenue. Now, we’re at $500 million. While we stay true to our mission, vision, and family owned business objectives – being the highest quality company in the industry, operating with complete integrity, focusing on collaboration, innovation, and meeting our clients’ needs – a lot has changed. We have invested heavily in new technology, increased the capabilities of the team, focused on employee and engagement, and launched new products. Growth is challenging, but it can be very rewarding as well.

As the CEO, what company strategies are you currently working on? Is there a part of the business that you are consistently involved in?

We are heavily focused on Lean Six Sigma methodologies to streamline our business. When you are growing fast, you don’t always focus on process. We are systematically reviewing all of our processes to improve quality for our clients and our riders. I never knew process improvement could be so fun, but we are loving it over here at MTM!

As our name implies, we encourage women to be brazen and bold! Tell us about a moment you were brazen in your business. 

MTM recently completed our first acquisition of a technology company. There is nothing more brazen than investment! We are very excited about moving in this direction – I’m more excited about the possibilities it provides than anything!


Follow Alaina and MTM on Facebook and Twitter @MTMSocial, on Instagram @mtm_inc, and visit their website at


For more than 20 years, MTM has partnered with our clients to develop innovative solutions for accessing healthcare, promoting independence, and connecting community resources. By leveraging high quality customer service and our ability to develop comprehensive provider networks, we help our clients accomplish their goals while achieving our vision of communities without barriers.

MTM is here to take on our clients’ biggest challenges in healthcare and public transit. From statewide non-emergency medical transportation (NEMT) brokerage to scheduling and dispatching for major transit agencies, our services aim to improve member health outcomes while aligning with client objectives, reducing program costs, and increasing satisfaction.