Care at home programs are helping U.S. hospitals combat chronic capacity bottlenecks, escalating labor costs, and clinical workforce burnout
Health systems’ traditional approaches to capital-intensive bed expansion or internal throughput optimizations have reached a point of diminishing returns. The modern hospital, burdened by an aging and increasingly complex patient population, is currently an inefficient engine for low-to-mid acuity care, and the consensus is clear: bringing healthcare into a patient’s home is a critical strategy for health systems.
Acute Care at Home (ACAH) safely extends acute and transitional care into the patient’s home with ongoing clinical support. Leading health systems, have partnered with myLaurel to make ACAH a core strategic asset to optimize high-acuity throughput and capture significant reductions in readmissions. Their ACAH programs show an ROI of 9:1 and exceptionally high patient experience scores.
A few of the challenges ACAH programs address include:
- Capacity and Throughput Failures: Emergency Department boarding and diversions represent lost revenue and limit the ability to treat incoming patients efficiently.
- Incomplete Transitions of Care: Despite best efforts inside the hospital, a discharge is often seen as a “victory” rather than the start of a vulnerable transition period, frequently leading to unnecessary readmissions and “recidivism.”
- Financial and Operational Strain: The prohibitive cost of capital construction ($1.5M+ per bed) and the pressure to improve margin on DRG-based care compel health systems to seek scalable, variable-cost models.
- Workforce Moral Distress: The friction between clinical quality and throughput efficiency is a primary driver of physician attrition.
Alongside leaders from Ochsner Health and Maimonides Health, Chris Dale, Medical Director, Clinical Innovation at Providence Health, recently highlighted the importance of care at home programs: “There is nothing more sacred or impactful than being in someone’s home and seeing their real life. It ‘flips the script’—it removes the power dynamic from the clinician and puts it in the hands of the patient. You are a guest in their home, engaging in their environment to truly understand their needs.”
The ACAH models these health systems have implemented strategically address three critical areas in the care continuum:
- ED/Observation Avoidance: Identifying high-risk, complex patients in the community or ED and treating them safely at home, thus avoiding unnecessary admissions. Deflecting low-acuity admissions to protect the ED for true emergent needs.
- Length of Stay (LOS) Reduction: Safely accelerating the discharge of stabilized inpatients (1.5 to 2 days early) for continued acute-level care at home. This relieves hospital bed pressure and provides physicians with reassurance of a safe landing for their patients.
- Readmission Reduction: Bridging the 30-day “vulnerability gap” through intensive in-home stabilization and virtual transitional care, focusing on patients with high social risk factors to prevent repeat utilization.
Today’s environment demands a new approach: a partnered, capital-light, and non-cannibalistic model that leverages external expertise to scale ACAH programs as an extension of the health system’s brand. These programs deliver significant results, including:
- Exceptional Patient Experience: Consistently high patient experience scores, with a Net Promoter Score (NPS) frequently in the high 90s.
- Reduced Readmissions: A decrease in reutilization among high-risk patients (for example, Ochsner Health decreased its recidivism rate from 30% to single digits).
- Increased Capacity: Greater bed capacity in the hospital, enabling the treatment of higher-acuity, margin-producing patients.
- High Return on Investment: A demonstrated 9:1 ROI.
Logan Davies, Ochsner Health’s Hospital Medical Director of Access and Throughput, commented on their results: “Through our ED and observation avoidance and readmission reduction programs, we have generated over 7,000 bed days of care—roughly 900 new admissions—within our current footprint. At this facility alone, we are generating 7.5 beds a day and almost a 9x return on investment. And we’re just getting started.”
By shifting the right patients to the right site of care, health systems can unlock inpatient capacity, optimize contribution margin, and deliver high-quality acute care in a setting patients increasingly prefer.
Matt Weissman, Chair of Medicine at Maimonides Health, says that their success is fundamentally built on partnerships. “By expanding these collaborations, we can drive down length of stay, increase satisfaction, and reduce readmissions. We must continue finding ways to utilize our resources better, shifting care outside the hospital to reduce the need for admissions and help patients get home faster.”
Care at home programs are one way to combat capacity surges in a way that treats the right patient, at the right time, in the right place. Health systems that implement these programs free hospital capacity, reduce costs, and improve patient outcomes.
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