extract: 2021-02-00-mckinsey-facility-to-home-265-billion-shift
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Teleo Agents
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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 requires massive home health workforce expansion, but McKinsey identifies 'stitchable capabilities' (dialysis, post-acute care, long-term care, infusions) as dependent on workforce availability. The gap between projected home care demand (3-4x current) and caregiver supply crisis creates structural bottleneck.
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Relevant Notes:
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@ -17,6 +17,12 @@ This inverts the current clinical paradigm. Instead of patients visiting doctors
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The wearable medical device market is $48.3B (2025) growing to ~$100B by 2030 at 15.6% CAGR. The broader digital health market is projected at $180B by 2031.
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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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McKinsey identifies RPM as core enabling technology for $265B care migration. The technology stack (wearables → AI middleware → clinical action) is explicitly positioned as the infrastructure layer that makes home-based care viable at scale. 16% of 65+ respondents more likely to receive home health post-pandemic, creating demand pull for continuous monitoring infrastructure.
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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 (confirm)
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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 represents 3-4x increase from current ~$65B baseline. Johns Hopkins hospital-at-home shows 19-30% savings vs in-hospital care. Home care for heart failure patients shows 52% lower costs. 94% of Medicare beneficiaries prefer home-based post-acute care.
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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 (extend)
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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 $29B → $138B (2024-2033) at 19% CAGR. AI in RPM specifically: $2B → $8.4B (2024-2030) at 27.5% CAGR. Home healthcare is fastest-growing RPM end-use segment at 25.3% CAGR. 71M Americans expected to use RPM by 2025, creating the data infrastructure for AI middleware layer.
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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", "continuous health monitoring is converging on a multi-layer sensor stack of ambient wearables periodic patches and environmental sensors processed through AI middleware.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 +58,18 @@ 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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- Up to $265 billion in care services (25% of total Medicare cost of care) could shift from facilities to home by 2025
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- Current home-based care serves approximately $65B, requiring 3-4x increase to reach $265B projection
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- Johns Hopkins hospital-at-home program shows 19-30% cost savings vs in-hospital care
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- Home care for heart failure patients shows 52% lower costs per systematic review
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- 94% of Medicare beneficiaries prefer home-based post-acute care
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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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- Remote patient monitoring market: $29B → $138B (2024-2033), 19% CAGR
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- AI in RPM market: $2B → $8.4B (2024-2030), 27.5% CAGR
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- Home healthcare is fastest-growing RPM end-use segment at 25.3% CAGR
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- 71M Americans expected to use RPM by 2025
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- Services already feasible for home: Primary care, outpatient-specialist consults, hospice, outpatient behavioral health
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- Services requiring 'stitchable capabilities': Dialysis, post-acute care, long-term care, infusions
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