Home Health: From Option to Imperative

Health systems face a pivotal strategic choice. Inpatient capacity is constrained, reimbursement pressure is intensifying, and leaders must manage rising acuity and shifting care patterns without eroding margin or fragmenting care delivery. Home health is no longer peripheral. It is fast becoming a central lever for operational stability and competitive positioning.

Of post-acute volumes in 2025, 47% were attributed to home health, and home health volumes are projected to grow 25% over the next decade. This is not simply demographic growth; it signals structural change. Higher-acuity patients are moving home, and skilled nurse visits are rising. Broader home visit models—spanning clinical and supportive services—are expanding even faster. The home is emerging as a coordinated site of care, not just a discharge destination.

The question is not whether to participate, but how quickly and how deliberately to act. Consumer expectations, payer pressure and advancing technology are accelerating the shift. Health systems generally fall into two categories based on the maturity of their home-based care capabilities. Emerging systems are those that have not yet built the infrastructure, workforce, partnerships or digital platforms required to support coordinated care in the home. Established systems, by contrast, have mature, integrated home health capabilities supported by virtual care and cross-continuum coordination. They view home health not as a stand-alone service line, but as a strategic asset that improves efficiency and strengthens competitive positioning.

One example of an established system with a stable home health foundation in place is Advocate Health. They have built an integrated, coordinated platform of care-in-the-home solutions to support their system goals—to provide seamless care for patients that enable them to stay in their homes and communities.

This platform goes beyond traditional home health to include inpatient-level care in the home. Its Hospital at Home program illustrates how virtual infrastructure can transform a pandemic-era response into a scalable care model. Originally launched by Atrium Health in 2020 to manage lower-acuity COVID-19 patients at home, the program has evolved into one of the largest hospital at home platforms in the country, supported by the scale of the Advocate Health merger and strategic partnerships. These include internal Mobile Medicine, which is paramount to the Hospital at Home program’s success.

Also central to Advocate’s expansion is the deliberate integration of remote patient monitoring and virtual visits into clinical workflows, enabling real-time oversight, targeted interventions and more efficient deployment of care teams. Advocate leadership has positioned virtual care not as an adjunct, but as the operational backbone of hospital-level care in the home—designed to improve responsiveness, support higher-acuity patients and capture cost efficiencies across the continuum.

Home health expansion is not a short-term trend. It is a directional shift in the architecture of care delivery. Systems that treat home health as a strategic platform—rather than a discrete service—will be positioned to convert forecasted growth into sustained advantage. For executive teams, the imperative is disciplined action: align strategy, infrastructure and investment now to ensure the organization shapes the migration of care to the home rather than reacting to it.

Note: Analysis excludes 0–17 age group. Home health forecast includes the combination of two procedures: home nurse visits and home visits other. Sources: Filbin P. Advocate Health’s strategies for hospital-at-home expansion. Home Health Care News. March 6, 2024; Impact of Change®, 2025; Proprietary Sg2 All-Payer Claims Data Set, 2023; The following 2023 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025, 2026.