Changing healthcare dynamics are driving a shift toward specialty care providers and post-acute care. The expansion of alternative sites of care underscores the importance of consistent evidence-based, patient-centered care across the continuum.
Healthcare delivery has traditionally been handled as a continuum across a person’s life — from birth to preventive care to acute interventions, post-acute recovery, and palliative care. Hospitals have been at the heart of this journey, providing critical services during a person’s most vulnerable moments.
However, a confluence of economic, regulatory, and consumer preferences are accelerating the shift away from traditional hospital settings to alternative sites of care. While the pace of this transition varies – and the models that are emerging differ – depending on market, local dynamics such as the physician landscape, infrastructure availability, health plan involvement, and regional regulations, it’s clear there is an both an evolution and expansion of care delivery.
These shifts underscore the need for healthcare systems to deliver evidence-based, patient-centered care in the right setting and at the right time. Increasingly, accountability for ensuring that care gets delivered across a continuum of care settings is not just a public health responsibility, but acute-care organizations are now on the financial hook through risk-based arrangements to make sure patients can move seamlessly from one care setting to the next.
That accountability is spurring an expansion of health systems into vertically integrated post–acute care systems, the development of innovative models like hospitals at home, and the establishment of specialty care organizations.
Amidst the rapid changes, hospitals are preparing for the implementation of CMS’ Transforming Episode Accountability Model (TEAM). Participating hospitals will be looking to partner with post-acute providers to help them improve patient outcomes and reduce care costs. TEAM is a mandatory bundled payment program scheduled to begin on Jan. 1, 2026, and run for five years. According to CMS, TEAM aims to improve quality and reduce costs by promoting care coordination. TEAM will apply to episodes including lower extremity joint replacements, surgical hip femur fracture treatments, spinal fusions, coronary artery bypass grafts, and major bowel procedures.
Emerging trends in specialty care delivery and post-acute care
With the aging US population and the rising prevalence of chronic diseases, demand for specialty-care providers has surged. The CDC reports that 60% of adults in the United States have at least one chronic condition, driving the need for specialized services in such areas as oncology, cardiology, and nephrology. That need for specialty care has led to significant investment in specialty networks like Thyme Care, which in 2024 raised $95 million in Series C funding to expand value-based cancer care.
The shift to specialty care providers and post-acute care facilities is also closely tied to the growth in value-based-care models, which prioritizes outcomes over volume. According to a 2023 McKinsey report, almost 60% of healthcare reimbursements are now tied to quality- or value-based arrangements, which encourages health systems to expand their presences in post-acute care and specialty services.
Among the post-acute care services that are experiencing rapid growth are skilled nursing facilities (SNFs), home health, and inpatient rehabilitation. The National Investment Center for Seniors Housing & Care found that occupancy rates at SNFs have continued to increase in the past few years, driven by patient preference for recovery in less-intensive settings. At the same time, the home health market continues to grow based on expectations that home health volumes will grow to 22% by 2034.
The trends are enabled by tools such as electronic health records (EHRs), telehealth, and remote monitoring devices, which facilitate communication between healthcare providers and serve to ensure that patients receive coordinated care regardless of setting. For example, Interwell Health’s integration of nephrology services across 2,600 dialysis clinics demonstrates how technology can unify specialty care and post-acute care.
Recognizing those changing dynamics, acute-care hospitals are broadening their care delivery models to include specialty and post-acute services. The expansion is enabled by strategic partnerships, acquisitions, and the establishment of integrated delivery networks (IDNs).
Key examples of care setting expansion strategies
- Post-acute-care partnerships: Many hospitals now partner with SNFs, home health agencies, and hospice providers to ensure continuity of care. For example, Providence Health operates Providence Home and Community Care, which provides home health and hospice services integrated with its acute-care facilities.
- Specialty-care networks: Hospitals are investing in specialty-care networks to manage complex chronic conditions. Notably, Cleveland Clinic developed its Heart, Vascular & Thoracic Institute, which offers specialized cardiovascular care across multiple settings.
- Ownership of post-acute-care facilities: Health systems like UPMC in Pittsburgh and Intermountain Health in Utah own and operate SNFs, rehabilitation centers, and home health care agencies, providing seamless extension of their acute-care services.
How change will affect evidence-based care
The shift toward specialty care networks and post–acute care both raises challenges and presents opportunities for the delivery of evidence-based care. One critical step is to maintain consistent, evidence-based practices across diverse care settings. Such consistency and standardization reduce variability, ensure quality, and improve patient outcomes.
The integration of specialty care and post–acute care also facilitates tailored interventions that meet specific patient needs. Evidence shows that patients recovering in specialized settings, such as inpatient rehabilitation or home health, experience lower readmission rates and faster recovery times. Additionally, the use of technology to standardize evidence-based practice can ensure consistent patient care across the continuum. EHRs and care coordination platforms enable providers to share data, track progress, and adjust care plans in real-time, fostering adherence to clinical guidelines.
Nevertheless, the opportunities will not be realized without healthcare-provider training in evidence-based protocols tailored to specialty care and acute-care environments. Investment in such workforce education ensures that staff become able to deliver high-quality care — and consistently.
Embracing a patient-centered future
The transformational changes to the care continuum reflect broader commitments to value-based care, patient-centered outcomes, and operational efficiency. To thrive in that changing environment, acute-care hospitals will have to assess how to best tap into the broader, more interconnected system.
By embracing the shift, healthcare organizations can ensure that patients receive evidence-based, high-quality care at every stage of their journeys. That kind of care not only improves outcomes but also positions providers to thrive in a value-driven healthcare landscape.
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