Are We Shifting Away From Hospital-Centered Healthcare?

Julie Shenkman
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Hospitals have long been the civilized world's primary health centers, but with home care becoming increasingly popular in the U.S., as well as an emphasis on preventative measures, hospital health care may see a steady decline in the coming years. Even hospitals themselves are shifting their focus, offering more outpatient treatment options whenever possible.

Hospital health care may never become irrelevant in modern society, especially because certain types of cutting-edge medical technology require this type of setting. However, needs such as senior care, physical therapy, disability needs and other basic non-intensive care needs may be met more affordably using home care. To get an idea of the shift from hospital health care, just look at the increasing need for home health aides, entry-level professionals who generally work under a registered nurse. According to the Bureau of Labor Statistics, job openings are expected to grow by 48 percent until 2022, which is much faster than average.

According to the National Conference of State Legislatures, the medical home model of health care has the potential to improve efficiency and treatment quality while reducing costs for patients receiving preventative or primary care. Dubbed the patient-centered medical home, this evolving model features an emphasis on preventing hospitalization, providing medical deliveries and utilizing a team of health care professionals that includes doctors, nurses, pharmacists and nutritionists. The Affordable Care Act enacted in 2010 supports the implementation of this model with large-scale Accountable Care Organizations and improved payment policies.

However, it is not just the government that is moving away from hospital health care. Blue Cross Blue Shield's PCMH model CareFirst has both reduced health care costs for members and reduced hospital usage according to Healio, and more than 80 percent of health care providers within the service area are participating in the program. Patients under CareFirst enjoy more than 11 percent fewer days in the hospital as well as roughly 6.4 percent fewer hospitalizations.

Outpatient models have proven effective time and again, and organizations are beginning to take notice. The Institute for Healthcare Improvement stated during a conference in 2013 that hospital health care must make a shift to community-based care solutions. The institute also expressed the need to switch from responding to illnesses to preventing them whenever possible. It urges hospitals to reach out to communities to both teach and understand diverse populations.

Home aides, outpatient nurses, medical delivery workers and medical equipment operators are sure to become more prominent professions in the coming years as the more practical, affordable PCMH and other outpatient models become the norm. The shift from hospital health care may never leave the facilities completely empty, but it is sure to help more Americans to get the help they need from the comfort of their homes.


Photo courtesy of artur84 at



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