Pivoting the Healthcare Empire: How At-Home Treatment Is Changing Care Delivery

Healthcare has long been a standard for millions of families across the globe. When someone we love gets ill, we resort to the nearest medical facility and rely on the care team to determine the most appropriate course of treatment.

But today, emergency rooms have become increasingly complicated. Demand for care is increasing while many healthcare systems continue to face constraints on bed capacity. Although hospitals are offering advanced treatments, the associated costs may remain difficult for some patients and healthcare systems to manage. Despite continued advances in medicine, hospital readmissions remain a concern for many healthcare systems.

Healthcare is widely considered essential, yet many patients and healthcare systems continue to face significant pressures.

Lon Hecht, CEO of Care2U, has worked in the industry for more than 25 years and sees firsthand why these flaws exist, and he says he is a firm believer that there’s another way. 

His solution? ER-level care delivered right to patients’ homes, allowing people to receive the treatment they need without the disruption, expense, and stress that come with a hospital visit.

By taking high-acuity care directly to where people live, Care2U’s model illustrates how changing the location of care may affect the patient experience while also reducing unnecessary healthcare costs.

Eliminating the traditional cost driver

Hecht saw an opportunity to grow Care2U because today’s hospitals are linked with unrealistic costs, he says. Traditional hospitals require enormous, additional investments in beds, equipment, staffing, and infrastructure that must be maintained, which naturally gets baked into the cost of every episode of care. 

While these investments are necessary for certain emergencies, some illnesses may be managed effectively outside a traditional healthcare facility, depending on the patient’s condition and clinical needs. For appropriate patients, bringing that same level of care into the home can reduce costs without compromising the quality of treatment, Hecht says.

“For many complex acute illnesses, the home is simply a better and far less expensive place to heal. We also avoid costs that hospital comparisons often miss, like the ambulance transport to the facility and much of the downstream post-acute utilization, since hospitalized patients are more likely to need skilled nursing after discharge. Treating patients at home helps preserve their mobility, independence, and support systems,” he says.

This means the financial benefits can translate directly into a better patient experience, Hecht says. Patients can avoid unnecessary hospital expenses while remaining in a familiar environment, surrounded by the people and routines that support their recovery most.

According to Hecht, “Care2U typically delivers a comparable episode of care for roughly a third of what they pay in Medicare and as little as a sixth of what they pay in Commercial. The financial story is only half of it, though, because our clinicians spend more than 60 minutes at the bedside instead of the five rushed minutes patients often get in a crowded ER, which creates real room to address advance care planning and social determinants that quietly drive future costs.”

Receiving appropriate care at home may reduce patients’ exposure to some infections associated with inpatient settings, which affects immunocompromised populations the hardest. They can also maintain greater mobility and independence rather than experiencing the physical disruption that can accompany a hospital stay. The savings are important, but the model may also offer patients a more familiar and personalized care environment.

Scaling a model with deliberate strategy

There are two things that have allowed Care2U to improve the financial advantage at its core.

First, sufficient patient density may help support the efficiency of the at-home model, while reimbursement from payer partners can contribute to its viability. These are two aspects that Care2U has specifically embedded into its New York market, with plans to expand into the Maryland market early next year. 

“Density is the single biggest economic lever, because when patients are clustered geographically, drive times stay short and our per-episode costs stay low, whereas long stretches between visits push costs up since we pay clinicians for their travel time, not just their bedside time,” Hecht says.

Understanding density helps the patient experience because it may help make home-based care a more sustainable option for participating providers and payers. Keeping costs lower means Care2U can deliver high-level treatment without passing the full financial burden of a traditional hospital episode onto the healthcare system and patients.

“The economics also compound on the patient side, because of how we bill: patients typically owe a specialist copay rather than a steep ER copay or hospital coinsurance, so they save meaningfully too,” Hecht adds.

For business leaders, the practical takeaway is to identify the largest cost driver in their operating model and test whether changing where or how the service is delivered could reduce it. Before expanding, they can pilot the approach in a concentrated market, track costs and customer outcomes, and use that evidence to determine whether the model is viable at a larger scale.

When industry pressure becomes opportunity

As the economy stands now, hospitals are getting expensive, while rising patient demands add even more pressure. At the same time, employers are absorbing significant increases in healthcare expenses, capacity constraints continue to affect emergency departments, and changes to Medicaid may place additional pressure on patients, providers, and healthcare systems. America’s aging population is also creating another layer of urgency.

These factors may help explain the growing interest in at-home healthcare programs, which is why Hecht says he sees this as a signal to rethink where and how care is delivered.

“Any shift in where care happens feels threatening before it feels like an opportunity,” he says. “Care2U answers all of the pressures at once, delivering ER and hospital-level care at a fraction of facility cost, adding capacity without a dollar of new construction, and reaching patients earlier, in the home, before a manageable problem becomes an emergency.”

Also in Hecht’s view, this approach may play a growing role in the future delivery of healthcare, and it’s an alternative he hopes will finally relieve the financial hurdles.

“My honest belief is that the smart hospitals will stop fighting this and start copying it, because a home-based hospitalization lets them shed a chunk of fixed overhead, charge the health plan less, and still improve their margin,” he explains. 

Prioritizing caregiving in the home

Crucially, the shift toward the home is not limited to acute healthcare, either. Companies like Applause Home Care, led by CEO Jim Prussak, are also part of the trajectory, demonstrating how care can be reimagined around the home for the patients who need critical attention. 

As a non-medical provider, the company’s caregiving approach similarly centers around giving aging adults the tailored care they need, where a “care partnering model” happens at home so individuals can make decisions about their own treatment, while the caregiver responds accordingly. For older adults who prefer to age at home, the model illustrates how home-based services may support certain immediate care needs.

Prussak continues, “‘Care partnering’ changes the basic premise from ‘one person gives care, and another receives it’ to ‘people work together around care.’ The older adult remains an active participant in decisions for as long as possible, rather than becoming the passive recipient of whatever the family decides.”

As caregiving responsibilities move home, Prussak notes that home-based care can actually help preserve both autonomy and family relationships as well. 

He says, “In-home care can represent a loss of independence if it’s imposed as ‘someone needs to take over,’ but it can also be a tool for preserving independence when it’s designed around what the older adult wants to continue doing. The distinction is between doing everything for someone and providing the support that allows them to keep doing what they can and want to do.”

Adapting services to changing healthcare needs and resource constraints

The need for more effective healthcare strategies is already apparent. Ultimately, it’s about broader education and an emphasis on why at-home care can sometimes work better. 

“The first is broad market awareness, because patients and caregivers largely do not yet know this is an option, and that kind of category education simply takes time to build,” Hecht says.

Prussak also explains how families need to start strategizing about care early before risks add up. “Don’t wait for the fall, hospitalization, crisis, or caregiver burnout to force the conversation. Sit down while everyone still has some breathing room and ask the older adult what matters most to them, what kind of help they would accept, what each family member can realistically contribute.”

Providing care at home may give healthcare organizations another way to tailor services to individual patients, and Care2U and Applause Home Care illustrate how some providers are adapting their services to changing healthcare needs and resource constraints. They are rooted in eliminating barriers and, importantly, creating a space where every player feels valued.

In an industry where the home is rarely considered, moving suitable services there could represent a significant change in how some forms of care are delivered.

This article is for informational purposes only and does not substitute for professional medical advice. If you are seeking medical advice, diagnosis, or treatment, please consult a medical professional or healthcare provider.

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