Tyler
In recent years, home-based care has rapidly transformed the healthcare delivery landscape, establishing itself as a central pillar to healthcare reform. What took footing as a necessity during the COVID-19 pandemic has evolved into a sustainable model for improving patient access and lowering costs. The rise of value-based care, increased demand for convenience and personalization, and widespread technological innovation has fostered a market where patients can receive clinical-level care in the comfort of their homes. As health systems and startups alike continue exploring ways to manage chronic disease and reduce utilization of hospital resources, home-based care has emerged as a compelling solution.
The scope of home-based care offerings began with essentials like primary care and post-acute support but has since evolved to cover a much broader range of services. Services now span from chronic disease management and medication reconciliation to urgent interventions, remote diagnostics, and even hospital-level care. Pioneering models like Hospital-at-Home—developed through studies at Johns Hopkins in 1995—first demonstrated the clinical feasibility and efficacy of offering home-based care as a substitute for treatment in an acute care hospital. It found that patients not only preferred this style of care, but that it reduced costs by an average of 32% and shortened the average length of stay from 4.9 to 3.2 days. This model has proven particularly effective for high-cost, high-need populations such as Medicare beneficiaries, individuals with mobility limitations, and patients who suffer from multiple chronic conditions. Patients within these groups often struggle most with barriers to care—like transportation, caregiving support, or health literacy—that traditional clinic-base care may fail to address.
Technology has played a critical role in enabling and scaling in home-based care. Remote patient monitoring (RPM), mobile diagnostic tools, virtual care platforms, and portable health solutions have made it possible to deliver high-acuity services in home with clinical precision and real-time oversight. These tools—such as glucose monitors, oxygen sensors, and in-home labs, for example—now allow early detection of health complications, enabling timely intervention before an emergency situation develops. It is these advancements which have enabled the rapid growth and success of large virtual platforms like Teladoc and Amwell.
For payers, particularly Medicare Advantage and Medicaid MCOs, this model aligns perfectly with the goals of value-based reimbursement: keeping patients out of high-cost settings while improving outcomes. In 2020, CMS launched its waiver-based program, the Acute Hospital Care at Home (AHCAH) initiative, which enabled hospitals to deliver inpatient-level care in patients’ homes. These waivers allow states to provide individuals who need long-term care with at-home or community-based services and supports rather than onsite treatment at a healthcare center. Since the program’s inception, over 350 hospitals across 137 health systems in 39 states have been approved to participate. With data supporting that home-based services could provide up to 25% of post-acute and long-term care in the home, it’s not surprising that these waivers continue to be amended.
Despite clear advancements being made in the space, regulatory fragmentation and uneven reimbursement policies have slowed home-based care’s adoption. In states like Connecticut, home care agencies have struggled to stay solvent as Medicaid reimbursement fails to keep pace with inflation. Workforce shortages, caregiver burnout, and the need for better interoperability between digital tools also present structural obstacles. Furthermore, equitable access must be addressed: broadband availability, home safety, and support from caregivers varies significantly by geography and socioeconomic status. Policymakers must consider these barriers when designing permanent payment models and incentives to sustain home-based care beyond temporary pandemic-era waivers.
The home-based care revolution is not a temporary phenomenon—it represents a foundational rethinking of where, how, and why healthcare is delivered. As technology continues to mature, and as payment reform pushes care away from fee-for-service toward outcomes-based models, home-based care is poised to expand dramatically. The challenge ahead lies in scaling these models equitably, integrating them with broader care ecosystems, and ensuring that the shift to home doesn’t just change the location of care—but fundamentally improves its quality and accessibility.
With physician shortages looming and medical school costs soaring, physicians hoping to pursue primary care have become harder to find. Clinician—namely Nurse Practitioners and Physician Assistants—are stepping up to fill the gap. Learn more about how clinicians and similar providers can affordable, high-quality care.
Physician-led ACOs are reshaping value-based care, offering a cost-effective model rooted in clinical leadership and accountability. How do these organizations outperform their counterparts and improve patient outcomes? Learn more about why this unique model is gaining traction in today’s evolving healthcare landscape.
Millions of Americans increasingly rely on emergency departments as their primary healthcare touchpoint, putting EDs in a unique position to bolster community health through disease screening. Proactive screening initiatives can save lives while reducing utilization—but how can EDs most effectively implement these tools?