---
type: source
title: "From Facility to Home: How Healthcare Could Shift by 2025 ($265 Billion Care Migration)"
author: "McKinsey & Company"
url: https://www.mckinsey.com/industries/healthcare/our-insights/from-facility-to-home-how-healthcare-could-shift-by-2025
date: 2021-02-01
domain: health
secondary_domains: []
format: report
status: unprocessed
priority: medium
tags: [home-health, hospital-at-home, care-delivery, facility-shift, mckinsey, senior-care]
---

## Content

### Core Projection

- Up to **$265 billion** in care services (25% of total Medicare cost of care) could shift from facilities to home by 2025
- Represents **3-4x increase** in cost of care delivered at home vs. current baseline
- Without reduction in quality or access

### Services That Can Shift Home

**Already feasible:** Primary care, outpatient-specialist consults, hospice, outpatient behavioral health
**Stitchable capabilities:** Dialysis, post-acute care, long-term care, infusions

### Cost Evidence

- Johns Hopkins hospital-at-home: **19-30% savings** vs. in-hospital care
- Home care for heart failure patients: **52% lower costs** (from systematic review)
- RPM-enabled chronic disease management: significant reduction in avoidable hospitalizations

### Demand Signal

- 16% of 65+ respondents more likely to receive home health post-pandemic (McKinsey Consumer Health Insights, June 2021)
- 94% of Medicare beneficiaries prefer home-based post-acute care
- COVID catalyzed telehealth adoption → permanent shift in care delivery expectations

### Enabling Technology Stack

- Remote patient monitoring: $29B → $138B (2024-2033), 19% CAGR
- AI in RPM: $2B → $8.4B (2024-2030), 27.5% CAGR
- Home healthcare: fastest-growing RPM end-use segment (25.3% CAGR)
- 71M Americans expected to use RPM by 2025

## Agent Notes
**Why this matters:** The $265B facility-to-home shift is the care delivery equivalent of the VBC payment transition. If the attractor state is prevention-first care, the physical infrastructure of that care is the home, not the hospital. This connects the payment model (MA/VBC), the technology (RPM/telehealth), and the care site (home) into a single transition narrative.
**What surprised me:** The 3-4x increase required. Current home-based care serves ~$65B of the potential $265B. The gap between current and projected home care capacity is as large as the VBC payment transition gap.
**KB connections:** [[continuous health monitoring is converging on a multi-layer sensor stack of ambient wearables periodic patches and environmental sensors processed through AI middleware]], [[healthcares defensible layer is where atoms become bits because physical-to-digital conversion generates the data that powers AI care while building patient trust that software alone cannot create]]
**Extraction hints:** The $265B number is well-known; the more extractable insight is the enabling technology stack that makes it possible — RPM + AI middleware + home health workforce.

## Curator Notes
PRIMARY CONNECTION: [[continuous health monitoring is converging on a multi-layer sensor stack of ambient wearables periodic patches and environmental sensors processed through AI middleware]]
WHY ARCHIVED: Connects the care delivery transition to the technology layer the KB already describes. Grounds the atoms-to-bits thesis in senior care economics.
EXTRACTION HINT: The technology-enabling-care-site-shift narrative is more extractable than the dollar figure alone.
