The Rise of Hospital-Centric Care

The home-based care landscape is undergoing a transformation. Recent data indicates that in 2026, providers are overwhelmingly prioritizing partnerships with hospital systems as the most promising avenue for growth. This represents a notable change from 2024, when both hospitals and physician offices were considered equally valuable referral sources, according to a new report sponsored by Homecare Homebase. The trend also differs slightly from 2025, where assisted living facilities shared top billing with hospital systems.

“In 2026, hospital systems remain dominant, with word of mouth and senior living close behind,” the report states. “This trend indicates that upstream clinical alignment is now more valuable than downstream volume.” This suggests a move towards integrated care models, where home-based services are seamlessly connected to hospital discharge planning and post-acute care pathways.

The report’s findings are based on a survey of 103 professionals within home-based care organizations, with a strong representation from leadership – 64% identified as C-suite executives, owners, vice presidents, or directors. The organizations surveyed also varied in size, with 53% serving between one and 100 individuals daily.

<h2>Hospital Systems Prioritize At-Home Recovery</h2>
<p>This shift isn’t solely driven by home-based care providers. Hospital systems themselves are increasingly recognizing the benefits of facilitating quicker transitions to home-based care.  The desire to enable patients to recover in the comfort of their own environments is a key driver.</p>
<p>“That’s where they get to eat their own food, be with their pets, be with their family,” explains Lisa Musgrave, senior vice president of post-acute and at-home services at Ascension. “We’re working really hard at supporting understanding their goals, their caregiver situation, their home environment and what they need to get them to home as quickly as possible.”  This patient-centered approach aligns with broader industry trends towards value-based care and improved patient outcomes.</p>
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<h2>Persistent Challenges: Staffing and Payment</h2>
<p>Despite the focus on growth and strategic partnerships, home-based care providers continue to grapple with significant challenges.  Staffing remains the most pressing concern, consistently ranking as the industry’s top hurdle for the past three years. Over half of respondents (55% in 2026) identified staffing as the greatest obstacle, indicating that while the situation may be stabilizing, it’s far from resolved.</p>
<p>“Staffing has ranked as the industry’s greatest challenge for three years running: 58% in 2024, 55% in 2025 and 55% again in 2026,” the report notes. “The steady percentage suggests the crisis may be stabilizing, but it remains unsolved. As providers continue adapting, this signals long-term workforce planning, not short-term fixes.”</p>
<p>Beyond staffing, changing payment dynamics are a major source of concern, followed by industry consolidation, market shifts, and regulatory changes. These financial pressures often exacerbate the staffing crisis, as competitive wages in hospitals and nursing facilities draw talent away from the home-based care sector.</p>
<p>“Each year, our role becomes more critical as more individuals choose to recover at home – often discharged earlier and sicker than ever before,” says Dave Totaro, former chief government affairs officer of Bayada Home Health Care and president and executive director of Hearts for Home Care. “Yet, CMS continues to undervalue this vital care by proposing reductions that threaten our ability to serve those most in need. These cuts exacerbate an already severe caregiver workforce crisis… Talented professionals are being driven away from home health into hospitals and nursing facilities where pay is often higher, further weakening a system that depends on their dedication.”</p>
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<h2>Technology and AI: A Path Forward?</h2>
<p>Home-based care providers are increasingly turning to technology, particularly artificial intelligence (AI), to address these challenges. While adoption rates vary, a significant portion of providers are actively exploring AI solutions.  Currently, 39% are evaluating potential tools, and almost a quarter (28%) are already utilizing AI on a daily basis.</p>
<p>Documentation is emerging as a prime target for AI implementation, with 38% of respondents identifying it as the area with the greatest potential for improvement.  Streamlining administrative tasks can free up clinicians to focus on patient care.</p>
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<p>Even simpler technological solutions can yield substantial benefits. Luke Rutledge, president of Homecare Homebase, points to medication reconciliation as an example. “That’s a huge win for the clinician, for the industry, for the patient,” Rutledge says. “It’s small things like that. We need to chase transcribing and [ambient] listening, but don’t overlook the real simple things that are already out there that can provide immediate value.”</p>
<p>What innovative strategies are *you* employing to navigate the evolving landscape of home-based care? And how are you leveraging technology to overcome the challenges of staffing and reimbursement?</p>

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