Why Advocate Health Is Ripe For Home-Based Care Innovation

While many health systems offloaded ancillary service lines following the pandemic, Advocate Aurora Health and Atrium Health doubled down on home-based care.

Those companies merging, and creating “Advocate Health,” has created one of the largest health systems in the U.S. But the merger has also formed an organization with a strong and wide commitment to home-based care.

“We are so fortunate that both of our legacy organizations had such strong commitment to home-based care,” Denise Keefe, the senior vice president of continuing health at Advocate Health, told Home Health Care News. “Now, it’s a matter of taking all of that commitment and saying, ‘What can this all look like in the future, and how can we build upon it?’ We’re excited about that.”


Advocate Health is still undergoing a large-scale integration process to turn the two legacy enterprises into one.

One of the key parts of that process will be looking at what each health system did – and does – well in the home. The goal is ultimately to build those capabilities on top of each other.

Advocate Health cares for about 6 million patients annually through about 150,000 employees, over 1,000 sites of care and 67 hospitals.


Advocate Health Enterprises – the investment arm of Advocate Aurora Health – has made a bevy of home-based care investments over the years. One of those investments includes the acquisition of Senior Helpers, one of the largest home care franchises in the country. Among other at-home service areas, the organization also has hospital-at-home and SNF-at-home programs.

Atrium Health, on the other hand, has been working on scaling the hospital-at-home model throughout its footprint with the help of Best Buy (NYSE: BBY).

“How do we build out this well-coordinated, innovative platform for care in the home?” Keefe said. “Because that’s where we’re going.”

After the merger, home-based care is still on the forefront of Advocate Health’s plans. The question is around how to do it bigger and better, according to Keefe.

While plenty of health systems did opt to hone in on core competencies during and after the pandemic, there are other health systems that continue to invest in home-based care.

Take Intermountain Health, for example, which recently added another home health agency to its portfolio. Like Advocate Health, Intermountain Health sees home-based care capabilities as a positive differentiator for health systems.

“We’re trying to be ahead of the curve,” Dr. Nathan Starr, the medical director of home services at Intermountain Health, said at Home Health Care News’ FUTURE conference. “We really believe, as a value organization, that by moving to the home, we identify so many factors that drive health that you cannot see in a clinic or a hospital. It’s no surprise that the patient is not succeeding and failing without identifying and fixing those factors.”

That’s what Keefe calls “committing to the whole patient.”

Advocate Health believes that its home-based care initiatives can be successful on their own. But, more importantly – and as Starr alluded to – it helps the entire operation take better care of patients, and, in turn, shift even more toward value-based care.

“It is that commitment to the whole patient,” Keefe said. “You really have to look at the patient holistically and longitudinally. I think that understanding is what drives our commitment to home-based care.”

Advocate Health’s future home-based care endeavors

Until the integration process is completed, and Advocate Health begins to feel and act like one, it’s hard to forecast what exactly home-based care operations will look within the health system long term.

But Keefe did have some details to share.

For instance, Advocate Health is going to continue work on its SNF-at-home program, which it is very bullish on. Currently, its testing out that program in Wisconsin with its ACO REACH population.

The plan is to eventually scale that program across its footprint.

“The skilled nursing facility market has changed so dramatically,” Keefe said. “There’s challenges for SNFs, with staffing, with access and otherwise. That’s why I think we’ve turned to that to say, ‘Alright, we know that this is a challenge for our health system. How do we build a model that helps us help them?’”

Keefe also believes the entire home-based care space will have to become far more tech-enabled in the near-term future.

“We need to be a lot more tech-enabled in the home,” she said. “We know that virtual care needs to be a part of it. We know remote patient management needs to be a part of it. There will be other technology, too, that we will need to make sure is part of us providing great care for the patients, but also driving efficient operations.”

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