extract: 2021-02-00-mckinsey-facility-to-home-265-billion-shift
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@ -33,6 +33,12 @@ None identified. This is a descriptive claim about measured workforce conditions
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AARP 2025 data confirms: 92% of nursing homes report significant/severe shortages, ~70% of assisted living facilities report similar shortages, all 50 states face home care worker shortages, and 43 states have seen HCBS provider closures due to worker shortages. Median paid caregiver wage is only $15.43/hour, yet facilities still cannot attract workers.
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### Additional Evidence (extend)
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*Source: [[2021-02-00-mckinsey-facility-to-home-265-billion-shift]] | Added: 2026-03-16*
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The $265B facility-to-home shift depends on home health workforce expansion during a period when facility-based care already faces critical workforce shortages. This creates a zero-sum competition for healthcare workers between facility and home settings, potentially constraining the transition speed regardless of payment or technology readiness.
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Relevant Notes:
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@ -28,6 +28,12 @@ The services ready to shift include primary care, outpatient specialist consults
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This facility-to-home migration is the physical infrastructure layer of [[the healthcare attractor state is a prevention-first system where aligned payment continuous monitoring and AI-augmented care delivery create a flywheel that profits from health rather than sickness]]. If value-based care provides the payment alignment and continuous monitoring provides the data layer, the home is where these capabilities converge into actual care delivery. The 3-4x scaling requirement ($65B → $265B) matches the magnitude of the VBC payment transition tracked in [[value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk]].
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### Additional Evidence (extend)
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*Source: [[2021-02-00-mckinsey-facility-to-home-265-billion-shift]] | Added: 2026-03-16*
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McKinsey projects $265B facility-to-home shift requires 3-4x increase in home care capacity from current $65B baseline. Johns Hopkins hospital-at-home demonstrates 19-30% cost savings vs. in-hospital care. Heart failure home care shows 52% lower costs. The gap between current ($65B) and projected ($265B) home care capacity is $200B, equivalent in scale to the entire VBC payment transition.
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Relevant Notes:
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@ -27,6 +27,12 @@ This claim connects the technology layer ([[continuous health monitoring is conv
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The atoms-to-bits conversion happens at the patient's home ([[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]]), and the AI layer makes that data clinically useful ([[AI middleware bridges consumer wearable data to clinical utility because continuous data is too voluminous for direct clinician review]]).
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### Additional Evidence (confirm)
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*Source: [[2021-02-00-mckinsey-facility-to-home-265-billion-shift]] | Added: 2026-03-16*
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RPM market projected to grow from $29B to $138B (2024-2033) at 19% CAGR. AI in RPM specifically: $2B to $8.4B (2024-2030) at 27.5% CAGR. Home healthcare is the fastest-growing RPM end-use segment at 25.3% CAGR. 71M Americans expected to use RPM by 2025. This technology stack is the enabling infrastructure for the $265B care site transition.
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Relevant Notes:
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@ -7,9 +7,13 @@ date: 2021-02-01
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domain: health
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secondary_domains: []
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format: report
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status: unprocessed
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status: enrichment
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priority: medium
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tags: [home-health, hospital-at-home, care-delivery, facility-shift, mckinsey, senior-care]
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processed_by: vida
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processed_date: 2026-03-16
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enrichments_applied: ["home-based-care-could-capture-265-billion-in-medicare-spending-by-2025-through-hospital-at-home-remote-monitoring-and-post-acute-shift.md", "rpm-technology-stack-enables-facility-to-home-care-migration-through-ai-middleware-that-converts-continuous-data-into-clinical-utility.md", "caregiver-workforce-crisis-shows-all-50-states-experiencing-shortages-with-43-states-reporting-facility-closures-signaling-care-infrastructure-collapse.md"]
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extraction_model: "anthropic/claude-sonnet-4.5"
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---
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## Content
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@ -54,3 +58,10 @@ tags: [home-health, hospital-at-home, care-delivery, facility-shift, mckinsey, s
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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]]
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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.
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EXTRACTION HINT: The technology-enabling-care-site-shift narrative is more extractable than the dollar figure alone.
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## Key Facts
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- 16% of 65+ respondents more likely to receive home health post-pandemic (McKinsey Consumer Health Insights, June 2021)
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- 94% of Medicare beneficiaries prefer home-based post-acute care
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- Services already feasible for home delivery: Primary care, outpatient-specialist consults, hospice, outpatient behavioral health
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- Services requiring stitchable capabilities for home delivery: Dialysis, post-acute care, long-term care, infusions
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