In that training, I learned body mechanics, skin integrity checks, how to take a blood pressure reading with a manual cuff, and how to communicate a change in condition to a nurse in under sixty seconds. It took weeks of classroom instruction and supervised clinical hours before I was cleared to provide hands-on care.
Nobody offered a refresher when my husband came home from the hospital needing the same level of care I’d been trained to give strangers.
That’s not a complaint. It’s an observation about how the system is designed. The discharge folder is thick, packed with follow-up appointments, medication lists, wound care instructions, and equipment order confirmations.
Sometimes there’s a printed care plan with sections and checkboxes, written for a clinician, because it was. Then the hospital doors close.
The hospital-at-home market is one of the fastest-growing verticals in healthtech. What it hasn’t solved is the person running the operation from inside that house — and what she was never taught before she got there.
When a patient moves from a hospital bed to their own bed, the clinical tasks don’t disappear.
They transfer to the family.
“Care at home” can be a formal Hospital-at-Home program, or the more common situation where someone is simply discharged and expected to recover. It means someone in that household is responsible for medication management, symptom monitoring, wound care, positioning, and knowing when something is wrong enough to call.
That someone rarely has clinical training. And the system rarely tells them that’s a problem until something goes wrong.
The specialty pharmacy runaround
I recently met a woman I’ll call “Ruby” at a local senior care expo. She’s her husband’s caregiver (he has Parkinson’s). She told me the story of when she spent 2 1/2 months cycling through 3 specialty pharmacies, while managing her husband’s progressive neurological disease at home. It’s enough to make your head spin.
The second pharmacy she worked with missed shipments repeatedly. When she complained, they apologized. When she asked, “How can we prevent this from happening again?,” they didn’t have an answer.
The next month, it happened again.
She eventually found a pharmacy that worked. But she had to do that legwork by herself, while managing everything else.
That story shows an example of what “care at home” actually transfers to families, and how ill-prepared they are for it.
Families Don’t Get CNA Training
The skills required to deliver safe care at home are taught in formal programs. It takes weeks to develop these skills. The people who have them go by different titles like:
certified nursing assistants (CNAs)
home health aides (HHAs)
patient care technicians (PCTs)
They’re all are paid professionals who spent time learning those specialized skills.
But family caregivers who do the same thing, unpaid, have nothing more than a folder with their loved one’s discharge papers.
Caregiving training
I know this from both sides, because I worked as a CNA and home health aide before I became a family caregiver myself. When my husband came home from the hospital needing hands-on physical care, I had training that most families never receive. (I got this training in the 90s and wasn’t offered a refresher course, but thankfully I still remembered the most important things.)
Caregiving training includes things like:
Body mechanics, which refers to a technique of how to reposition someone safely without injuring your own back.
A skin integrity check, where you run your hands across pressure points, looking for the redness that precedes a pressure ulcer.
How to properly take someone’s blood pressure with a cuff that you pump yourself.
Communicating a change in condition to a nurse who has 90 seconds for your call, means you have to know which words to say them so your concerns are taken seriously instead of getting triaged to voicemail.
The training teaches you what to look for, why, and the physical consequences of doing it wrong.
I happened to have those skills, but most family caregivers don’t. The gap between what the care plan assumes and what families actually know is where preventable complications live.
Caregivers continue to be overlooked and underappreciated
To quote AARP CEO Myechia Minter-Jordan:
“Family caregivers are a backbone of our health and long-term care systems — often providing complex care with little or no training, sacrificing their financial future and their own health, and too often doing it alone.”
That’s the operating reality the care-at-home market is building into.
According to AARP’s 2025 Caregiving in the U.S. report, only 11% of family caregivers receive any formal training to help with activities of daily living like bathing, dressing, mobility, while two-thirds are doing those tasks. Only 22% receive training for medical or nursing tasks, yet the majority assist with them anyway.
The care is happening, but the prep is sorely lacking.
The Healthcare Market Is Building Around a Patient and Caregiver Education Gap (Instead of Trying to Close it)
There are 63 million family caregivers in the United States — nearly one in four adults — and most of them are managing complex medical tasks at home with little or no formal skills training, according to AARP’s 2025 Caregiving in the U.S. report.
That’s who the hospital-at-home market is building for, whether it’s named that way or not.
The hospital-at-home market is one of the most active verticals in healthtech. It includes remote patient monitoring (RPM), care coordination platforms, and discharge planning tools.
Venture capital has been moving into this space for years, and CMS policy is accelerating that movement with models like the ACCESS program starting July 5, 2026.
But most of the investment is going into the clinical and operations (monitoring devices, alert systems, and care team workflows). Meanwhile, education for family caregivers who executing the care plan are doing so from a thinly packed folder and random online searches.
Let’s say an RPM device sends a blood pressure alert to a clinician. The family caregiver is in the room with the patient, trying to decide whether they should call 911 now, or wait for the nurse to call back.
The device works and the clinical protocol is in place. But the person in the room hasn’t been taught how serious a blood pressure of 160/100 is, or what to say when the nurse calls.
The device has a protocol, but the person in the room just has a folder.
That gap is not a caregiver failure; it’s a system design gap.
The Consequences of Not Pre-Educating Patients and Caregivers
When patients and their caregivers are not educated on these important measures, it shows up in:
hospital readmissions
ER visits
care collapses
The person trying to follow the care plan didn’t have what they needed to execute it safely.
30-day readmission rates for patients with complex chronic conditions like heart failure, kidney disease and COPD run from 15% to 25%.
Every readmission is expensive for the patient and the hospital, and many of are preventable.
The research on what drives preventable readmissions consistently points to the same factors: inadequate discharge preparation, insufficient caregiver support, and gaps between what the care team assumed the family could manage and what the family actually knew how to do.
Caregiver-led errors aren’t usually due to negligence. A family caregiver who doesn’t know how to recognize early wound infection isn’t being careless. They do what they knows how to do, which is not the same thing as what a CNA or nurse knows.
The caregivers who manage complex care at home without preventable crises aren’t lucky. They’re either trained, or they’ve been through enough that they’ve built up their knowledge and skills the hard way.
Both of those are expensive ways to learn.
The most effective thing a healthtech company building in the care-at-home space can do is:
Involve patients and caregivers as they develop the product, and
Treat the family caregiver as an important care team member who needs onboarding just like paid nursing staff.
What Good Preparation Looks Like
The caregivers who manage well have information the others don’t.
Pre-discharge caregiver education typically covers things like:
What to watch for and when to call. Not every change in condition is a 911 situation, but families need a decision framework for the middle ground. Fever thresholds, wound appearance, changes in breathing, altered mental status — what each one means and what to do next.
How to move someone safely. Body mechanics aren’t intuitive. Caregivers who aren’t taught proper transfer and repositioning techniques injure themselves, sometimes seriously, within the first weeks of providing care. The patient isn’t the only one at risk.
What the medications actually do. Not the full pharmacology, but enough to recognize when something looks wrong. Knowing that a missed dose of a Parkinson’s medication can trigger a rapid symptom change is different from knowing the drug’s mechanism of action. Families need the former. They rarely get either.
How to work alongside home health aides. A home health aide visits for a few hours. The family caregiver is there the rest of the time. Without a clear handoff structure with what the aide observed, what changed, and what the caregiver needs to know, continuity breaks down between visits, and nobody flags it until something escalates.
None of this is complicated to teach. It requires someone deciding it’s worth teaching before the patient comes home.
I started Care Without Compromise because I know how it feels when you’re handed a folder and expected to figure it out. That newsletter exists for the people inside those houses.
This article is for the people building the tools they use.
If your product ends up in a family caregiver’s hands, the question you should ask is what they need to know so they can use it safely.
That’s the work I do. I write patient education and onboarding content for healthtech companies that are ready to close that gap. If that’s the conversation you’re trying to have, this is the place to start it.
Your patients don’t stop using your product because it’s bad. They disengage because no one taught them how to use it, nor explain why they should.
I didn’t come to patient education content through a certification program or a content strategy course. I came to it through a stack of medical devices on my nightstand, a peritoneal dialysis machine running in my living room every night, and the slow realization that every piece of content we received about managing George’s conditions had been written for someone who wasn’t us.
Not because we weren’t capable. Because we were overwhelmed — and nobody who wrote that content had accounted for the difference.
I’ve thought about that a lot since I started writing onboarding and education content for healthtech companies. The information existed. The problem was never the information. Someone just packaged it for a patient who doesn’t survive a serious diagnosis intact.
Most healthtech SaaS companies solve the post-signup silence with a drip sequence where:
A welcome email goes out on Day 0.
Something like “here’s what you can do with the platform” follows on Day 3.
A check-in on Day 7.
The sequence runs automatically, open rates look fine, and then the team moves on to the next.
Drip sequences were built for marketing to move a prospect through a funnel, warm them up before a sales conversation, and keep a brand top of mind.
They’re timed and trigger-based. They’re also written for someone who has attention to spare. Not a patient living with 3 chronic conditions, and trying to figure out why their reading looks wrong.
The assumptions inside a standard drip sequence don’t hold up in a patient onboarding context. The assumption that information delivered on a schedule gets absorbed on that same schedule. The assumption that a “next steps” email sent on Day 7 will be acted on by Day 8. The assumption that if you include the information, people will find it.
None of that is how it works when someone is exhausted, managing competing health priorities, and staring at a device they don’t fully understand yet.
What an educational email course does differently
Here’s the difference:
A drip sequence asks: when should we contact this user?
An educational email course asks: what does this person need to understand to succeed, and in what order?
That difference changes the structure, the language, the pacing, and honestly, the results.
Each email has one job—one specific action the patient can complete within 5 minutes. The sequence is built so that Day 1 makes Day 2 easier, and Day 2 makes Day 3 make sense.
The patient is being walked through a process, not nudged along a timeline.
That’s almost everyone who uses your product. If your onboarding assumes otherwise, you’re starting with a comprehension gap you’ll never close.
The communication problem runs deeper than literacy alone. According to the 2026 State of Patient Communications Report, 87% of providers rate their patient-facing technology as up to date. But only 25% of patients report receiving multiple proactive outreach attempts from their provider in the past year.
Providers believe they’re communicating. Patients aren’t experiencing it that way. That’s not a technology failure. That’s a content and sequencing failure, and it shows up in the same activation data you’re already tracking.
Critically, each email explains why patients should do what they’re being asked to do. Instead of just saying “take your blood pressure twice daily,” explain that twice-daily readings produce the pattern data your care team needs to catch a problem before it becomes an emergency.
Patients who understand the reason behind an action are significantly more likely to do it consistently.
Medication adherence research has documented this for decades. The same principle applies to every health behavior your product depends on.
Which version works better?
Here’s an example with 2 versions of the same onboarding instruction for an RPM blood pressure monitor:
Version A:“Ensure proper cuff placement at heart level for accurate systolic and diastolic readings.”
Version B:“Wrap the cuff around your upper arm so the bottom edge sits about an inch above your elbow. The tube should line up with the inside of your arm. Sit quietly for 5 minutes. Even a short walk can affect your reading.”
It’s the same information. Version A passes regulatory review, but Version B is the one people can actually follow.
The patient who reads Version A and gets a confusing number will assume they did something wrong, feel embarrassed about it, and probably not try again. The patient who reads Version B has enough context to troubleshoot on their own.
That’s the difference between content written for compliance and content written for comprehension. (You can be both, by the way. It just takes more effort.)
How PX problems affect your business
Patient engagement isn’t abstract for a Series A or B healthtech company. The patient experience (PX) shows up in:
Contract renewal discussions
The number of re-onboarding calls your customer success team has to field
Churn
When patients don’t activate your device, or when they half-set-up the device and drift away, the cost lands somewhere—on your CS team, your NPS score, and eventually your retention numbers.
A well-built educational email course is cheaper than all of that. It also isn’t a knowledge base article, an in-app tooltip, or a PDF in the resource center that nobody opens. It’s a structured sequence that meets patients where they already are — in their inbox in plain language, in the right order, at the right moment.
Most healthtech companies haven’t built one. That gap is not small.
The companies that avoid these issues asked a different question: “Did anyone understand our email well enough to act?”
That question changes everything downstream: the structure, the language, the sequence, and ultimately whether the patient who needed the product most ever got anything out of it.
Half the people logging into patient portals aren’t patients. They’re caregivers, and the AI being built on top of those systems doesn’t know that.
In March 2026 I attended a Microsoft Copilot Health demo and a patient-centered AI panel hosted by the National Health Council. The technology was impressive. The conversation was thoughtful. And the caregiver — the person managing someone else’s health, signing forms under pressure, and navigating systems that were never built for them…
… was invisible.
This article reflects what I think needs to change before we build the next layer of health AI on the same blind spot.
Copilot Health is a consumer-facing AI health companion that pulls from multiple data sources simultaneously with:
Medical records from connected providers
Lab results
Wearable data from Apple Health or an Oura ring
Previous health conversations from within the Copilot ecosystem
Uploaded documents
It’s all synthesized into a single, conversational interface.
The demo persona was “Margaret.” She’s 50 years old with a history of hypertension, Type 2 diabetes, high cholesterol, and a recent heart attack (an NSTEMI requiring emergency hospitalization in January 2026). Her health profile showed 7 active medications, an HbA1c of 8.1% against a target of 7%, a resting blood pressure averaging 136/87, and sleep averaging 5 hours a night from her wearable data.
She asked why she was taking metoprolol, which is common after a serious cardiac event when discharge summaries are hard to process in real time. The system explained the medication, what it does, and invited follow-up questions about side effects.
When she entered in the Copilot that she’d woken up with severe jaw pain, Copilot flagged it as a potential cardiac symptom and recommended calling 911 immediately.
That’s not a trivial capability. For someone managing multiple chronic conditions, trying to understand why they’re on seven medications, wondering whether a symptom is serious, this tool offers something the healthcare system rarely does: an answer, in plain language, right now.
Rachel Gruner led the demo for Microsoft, and described the goal clearly: bring everything together, make it usable, help people navigate care. She named the 3 a.m. moment explicitly, being someone searching for health answers because they can’t reach a doctor. Someone who needs information and has nowhere else to turn.
She was describing a patient. But she was also unknowingly describing a caregiver.
The Number Nobody Mentioned
Here is a statistic that did not come up once during the demo, nor during the hour-long panel that followed it.
According to the Health Information National Trends Survey (federal data collected by the National Cancer Institute), the number of people logging into a patient portal on behalf of someone else more than doubled between 2020 and 2024. It went from 24% to 51%.
Half the people navigating these systems aren’t patients. They’re caregivers, like:
A daughter checking her mother’s lab results after a cancer scare.
A husband refilling his wife’s prescriptions while she recovers from surgery.
An adult child scheduling a follow-up for a parent who doesn’t speak English.
A spouse who has memorized every medication, every specialist, every prior authorization number (because if they don’t, no one will)
They’re exhausted, scared, and running someone else’s health on top of everything going on in their own life. And they are doing it inside systems that were never built to recognize them.
Most patient portals still don’t have a proper caregiver login. The formal proxy access process, where it exists, is often so confusing or slow that caregivers just use the patient’s credentials instead. So there’s no:
Audit trail
Role separation
Way for the system to know who’s logged in asking questions, making decisions, or interpreting results
Copilot Health connects to health records, wearables, and labs. It builds a profile over time based on conversations and data. It learns.
But what is it learning from? And about whom?
If half the behavioral data flowing through these systems is caregiver behavior that the system is reading as patient behavior (usage patterns, questions asked, drop-off points, topics searched at all hours of the night), then the AI being trained on that data has a foundational problem.
Patient-centered AI built on a misread of who the patient actually is isn’t patient-centered. It’s just a more confident version of the same blind spot.
What the AI Actually Learns
Maya Friedman, Director of Product Design and UX at Tidepool, made an observation about Copilot Health that she shared during a CES session in January 2026. She noted that the system synthesizes data across multiple sources to provide guidance. And in doing so, it creates a layer of coherence on top of information that was never designed to fit together.
Health records, wearables, and labs all operate on different standards, different levels of reliability, and different contexts.
Copilot doesn’t fix that fragmentation. It builds a coherent surface on top of it.
That coherence is genuinely useful for the person searching for answers at midnight. It’s also the source of risk.
A confident answer that’s built on misidentified behavior is harder to question than an incomplete answer. Think of the person on the other end of that conversation. A caregiver who has learned medical terminology not in school but out of necessity, who is tired and has 17 other things to manage, is not going to interrogate the data sources behind the insight. They’re going to act on it.
There’s a compounding problem that goes beyond accuracy. As these tools learn over time, they build profiles with personalization. They adapt to the user.
But if the system thinks the user it’s serving is Margaret, while the actual user is Margaret’s daughter navigating her mother’s post-cardiac recovery from three states away, then the personalization is wrong from the first conversation. And it compounds with every interaction.
The AI is getting better and better at serving the wrong person.
This isn’t an argument against tools like Copilot Health. It’s that the founders who build these tools should be precise about who they’re actually serving and build it accordingly. The 3 a.m. user isn’t always the patient. Sometimes she’s the person who can’t sleep because she’s worried about someone she loves and doesn’t know who else to ask.
She deserves a system that knows she’s there.
Ownership vs. Control
David Jost, Chief Technology Innovations Officer at the Epilepsy Foundation, said something during the panel that I haven’t been able to stop thinking about.
“Ownership and control are not the same thing.”
He was making a technical point about data governance — about the difference between having rights to your data and having actual agency over how it moves, who sees it, and what it’s used for.
But as a former family caregiver, I heard it as something more personal.
I owned my husband’s story. I was in every appointment. I tracked every medication change, every lab result, every specialist referral across multiple chronic conditions (diabetes, kidney failure, cancer, and limb loss). I knew his conditions better than most of the providers treating him.
But I didn’t control what happened to his data.
When we signed intake forms — and we signed a lot of them — we did it because we needed to get into the room. Steve Winawer, Head of Data, Digital, and Technology at Takeda described this dynamic plainly during the panel: “You walk into a doctor’s office. You sign the forms because what you want to do is see the doctor. You don’t really read them.”
That consent is what the entire data ecosystem is built on.
Not informed consent in the full sense of the phrase.
Transactional consent. The kind you give because the alternative is not being seen.
For caregivers, this is even more layered. You’re not just consenting on your own behalf. You’re consenting or not, because often there’s no mechanism to do so separately on behalf of someone else. Someone who may not be able to read the form themselves. Someone whose data is being collected, moved, and used in ways neither of you will ever fully trace.
Owning your health data and controlling it are two different things. Most of us have the first. Almost none of us have the second.
As AI health tools expand to connect more records, pull more data and build richer profiles, the gap between ownership and control will widen.
And caregivers, who have always been the system’s most active unpaid navigators, will feel that gap the most.
The Longer History
At the end of the panel, I asked about Henrietta Lacks.
Henrietta Lacks Source: Jstor.org
For those unfamiliar: Henrietta Lacks was a Black woman whose cancer cells were taken during a medical procedure in 1951, without her knowledge or consent. Those cells, known as HeLa cells, became one of the most important biological tools in modern medicine. They contributed to the polio vaccine, to cancer research, to countless pharmaceutical breakthroughs. The medical system built billions of dollars of value on her biology.
Her family only found out decades later.
I asked the panel: as AI systems become better at attributing value to data — tracking whose information contributed to which insight, which drug, which discovery — what can we learn from Henrietta Lacks about making sure that value flows back to the people it came from?
Heather Flannery, Founder and CEO of AI MINDSystems Foundation, gave the only answer, and it was direct.
She said that the same technologies being developed for computational governance and democratic-scale consent (making it possible to track and trace how data moves through a system) can also administer value attribution. Verifiably, continuously, and at scale.
Contributions of training data, lived experience, insight, problem-framing and caregiving itself are all valuable. None of it is currently tracked, traced, or remunerated.
The same infrastructure that fixes consent, Heather said, can fix attribution.
Henrietta Lacks didn’t consent. Caregivers consent constantly to forms they don’t read, in moments when they have no other choice, on behalf of people who are too sick or too scared to read them either.
The extraction looks different, but the pattern is the same.
The history of health data in America is, in part, a history of taking value from people who were never designed to benefit from the systems they fed. That history didn’t end in 1951. It continues every time a caregiver logs into a portal, answers a chatbot’s questions, uploads a discharge summary, and walks away having contributed data to a system that will use it to build something she will never own and cannot control.
National Minority Health Month exists to name these patterns. The question for this moment in health AI is whether we’re going to repeat them, or build something different.
What Caregivers Should Ask For
This is not an argument against AI in healthcare. The Copilot Health demo showed real capability. The panel included people genuinely committed to getting this right. The conversation about data sovereignty, computational governance, and equitable AI is happening — slowly, imperfectly, but sincerely.
This is an argument for specificity.
Patient-centered design that ignores the caregiver isn’t patient-centered. It’s incomplete. And the window for building these systems correctly is now, before:
the behavioral data compounds
the profiles deepen
the coherence layer becomes too established to question
So here’s what caregivers should be asking for, from the tools being built, from the organizations building them, and from the policymakers shaping the rules:
A login that knows who you are. Not a workaround. Not a borrowed password. A formal caregiver access model that distinguishes your behavior from the patient’s, maintains an audit trail, and allows the AI to serve you based on your actual role.
Proxy access that takes minutes, not phone calls. The formal process exists in some systems. It is almost universally too slow, too confusing, and too rarely completed. If half your users are caregivers, that’s not an edge case for product teams to accommodate. That’s their primary use case.
Consent that means something. Not a form signed under duress. A clear, plain-language explanation of what data is being collected, how it will be used, and what the caregiver retains the right to revoke. Separately from the patient’s consent, because the caregiver is a separate user with separate stakes.
AI trained on who’s actually in the room. If the behavioral data flowing through these systems includes caregiver behavior, the models need to know that. Not to exclude it — to interpret it correctly. The questions a caregiver asks at 3 a.m. are different from the questions a patient asks. The guidance each one needs is different too.
Recognition that caregiving is a data contribution. The labor of coordinating care, navigating systems, tracking medications, interpreting results, and advocating in clinical settings generates information that health AI is being built on. That contribution deserves to be visible, and eventually, as the infrastructure Heather described matures, remunerated.
If you’re a caregiver navigating any of this, my newsletter Care Without Compromise goes deeper on the practical and systemic dimensions of what it means to manage someone else’s health in a system that wasn’t built for either of you.
The tools are getting smarter. Let’s make sure they’re learning about the right person.
Sources
Health Information National Trends Survey (HINTS) 2024, National Cancer Institute.
PXI Q1 Convening: Building the Patient-Centered AI Ecosystem, National Health Council, March 26, 2026. Microsoft Copilot Health demo presented by Rachel Gruner. Panel quotes from David Jost (Epilepsy Foundation), Heather Flannery (AI MINDSystems Foundation), Steve Winawer (Takeda), Ian Miller (Digital Medicine Society); moderated by Rene Quashie (Consumer Technology Association).
Hospital-at-home programs have expanded rapidly across the U.S., but most patients have no idea this option exists when facing admission.
When my husband George was cycling through hospital stays every month for his end-stage renal disease and cancer in 2018, nobody told us there might be another way. We assumed the hospital was our only option. Month after month, we dealt with the ER waits, the uncomfortable chairs, the sleepless nights, and the parade of specialists who never seemed to talk to each other.
Things have changed since then. Hospital-at-home care has gone from experimental to mainstream. Medicare now covers it permanently. Your insurance probably covers it too.
But you have to know to ask for it.
Let’s break down everything you need to know about hospital-at-home versus traditional hospitalization, including:
a comparison of clinical outcomes
the hidden costs nobody talks about
how to decide which option makes sense for your situation
Hospital-at-home means exactly what it sounds like: you receive acute-level medical care in your own home instead of in a hospital facility. This isn’t the same as regular home healthcare or skilled nursing. We’re talking about the same intensity of care you’d get if you were admitted to a hospital bed.
What conditions qualify for hospital-at-home care?
The key word here is “acute.” You need to be sick enough to require hospitalization, but stable enough to be safely monitored at home.
What does hospital-level care actually include?
Your care team visits you at home daily, and sometimes twice a day. This includes physicians, nurses, physical therapists, and care coordinators. You’ll get IV medications if you need them. You’ll wear devices that monitor your vital signs and send data to your medical team in real-time. It’s like having a hospital room set up in your living room, but without the hospital smell and terrible food.
When George was using his Dexcom continuous glucose monitor, I got alerts on my phone whenever his blood sugar spiked or dropped dangerously low. That technology exists for heart rate, oxygen levels, blood pressure, and more. Your care team watches these numbers from their computers and can intervene before small problems become emergencies.
Who provides the care?
A dedicated hospital-at-home team manages your case. You’ll have a primary physician who oversees your treatment plan. Nurses visit to check on you, administer medications, and assess your condition. The big difference from traditional home health? These visits happen daily, and you have 24/7 access to your care team by phone or video.
When you’re admitted to a traditional hospital, you check in through the emergency department or for a scheduled admission. A nurse takes your vitals, you change into a hospital gown, and you’re assigned to a room (if one’s available—sometimes you wait for hours).
The hospital routine
Nurses check your vitals every few hours, day and night. Yes, even at 3 a.m. Doctors round in the morning, usually between 7 and 10 AM. If you’re asleep when they come by, too bad. Meals arrive on a fixed schedule whether you’re hungry or not.
With George’s 10 different specialists, we never knew who would walk through the door or when. His nephrologist didn’t talk to his oncologist. His endocrinologist had no idea what his cardiologist prescribed. I became the central hub of information, keeping my own spreadsheet because the hospital’s electronic records didn’t seem to connect the dots.
Family involvement and visiting limitations
Even before COVID-19 restrictions, hospitals limited visiting hours. During the pandemic, many hospitals banned visitors entirely. In 2025, most facilities still have restrictions like limited hours, limited number of visitors, no children under 12.
If you want to be there when doctors round to ask questions, you’d better arrive early and stay all day.
Need to go home to shower or check on your kids? You might miss critical conversations about your loved one’s treatment plan.
That’s not surprising. People sleep better when they’re in their own beds. They get to eat their own food, and see their family members whenever they want.
The medical care is just as good, but the experience is dramatically better.
Hospital readmission rates
Getting sent back to the hospital within 30 days of discharge is a sign something went wrong.
That’s because closer monitoring catches problems earlier. Patients understand their care plan better because they’re not overwhelmed and sleep-deprived. The transition from acute care to regular life is smoother when you’re already home.
The mortality rates? Comparable. For appropriate patients, hospital-at-home is just as safe as traditional hospital care.
The Hidden Costs Nobody Tells You About
The hospital bill is just the beginning. Let’s talk about what you’ll actually pay and what costs don’t show up on an invoice.
Out-of-pocket expenses for traditional hospitalization
Even with good insurance, a three-day hospital stay can cost you $1,500 to $3,000 in co-pays and deductibles. That’s the baseline. Then come the surprise charges.
Facility fees can add hundreds of dollars:
Labs processed by an out-of-network pathologist costs extra.
And let’s not forget parking. $15 per day adds up when you’re visiting daily for weeks. Hospital cafeteria meals for family members is $10 to $15 each.
These “small” costs can easily hit $500 to $1,000 for a typical hospital stay.
Out-of-pocket expenses for hospital at home
Medicare covers hospital-at-home the same way it covers traditional hospitalization. You pay the standard hospital deductible and any applicable co-pays. Most private insurers follow Medicare’s lead, but coverage varies.
The surprise? Hospital-at-home often costs you less out-of-pocket because there’s no:
You might need to buy a few things—maybe a shower chair or grab bars if you don’t have them. But the program provides equipment like IV poles and monitoring devices.
The invisible costs for caregivers
The economic impact on caregivers is often overlooked. I burned through my vacation days and sick leave taking George to appointments and managing his care, even while working remotely. Many caregivers do the same.
Both hospital settings require serious caregiver involvement, just in different ways.
Caregiving during traditional hospitalization
You become an advocate and information manager. When doctors round at 8 a.m. and you can’t be there because you have a job, you miss critical conversations. So you take time off. You show up early. You stay late.
I kept notes from every specialist visit, cross-referenced medications, and flagged contradictions. The nutritionist told George to eat high-protein foods for his kidney disease. The renal dietitian told him to eat low-protein foods for his kidney disease. Guess who had to figure that out?
You’re also managing communication with the rest of the family. Who’s visiting when? Who needs updates? Coordinating schedules becomes a part-time job.
Caregiving with hospital at home
At home, you’re more hands-on with daily care:
You help your loved one to the bathroom.
You make sure they eat.
You learn to manage medications (when to give them, and spot side effects)
The medical team trains you. They don’t just hand you a list of tasks and disappear. They show you how to help with care, what to watch for, and when to call for help.
When I was managing George’s peritoneal dialysis at home, his nephrologist’s team trained me thoroughly. I set up the machine every night, monitored the process, troubleshot issues.
It was a big responsibility, but I wasn’t alone. I had 24/7 access to the dialysis team by phone.
The benefits of hospital-at-home care:
You have more control over the environment
You can maintain some routine
You sleep in your own bed
The stress of feeling “on call” is real, but many caregivers prefer it to feeling helpless in a hospital where they can’t be present all the time.
How to Know if Hospital at Home is Right for Your Situation
Hospital-at-home isn’t for everyone. Here’s how to figure out if it makes sense for you.
Medical eligibility criteria
Your condition needs to be serious enough to require hospitalization but stable enough to monitor at home. This includes conditions like:
Pneumonia (non-ICU level)
Heart failure exacerbations
COPD flare-ups
Cellulitis and other serious infections
Certain post-surgical recoveries
You don’t qualify if you need ICU-level care, constant monitoring, or procedures that can only be done in a hospital. You also need to live within 30 minutes of the hospital in case you need emergency transfer.
Home environment assessment
You need a space for medical equipment, like a corner where an IV pole can stand and monitoring equipment can plug in.
If you’re taking advantage of telehealth, you’ll also need reliable internet for video visits and data transmission and a phone.
Safety matters too. Can you get to the bathroom safely? Are there trip hazards that could cause falls? A nurse will assess your home before admission to make sure it’s appropriate.
Insurance coverage check
Call your insurance company and ask these specific questions:
“What’s my co-pay compared to traditional hospitalization?”
“Do I need pre-authorization?”
“Which hospitals in my area participate in your hospital-at-home network?”
Get the answers in writing. Insurance representatives make mistakes, and you don’t want surprises later.
Family readiness factors
Someone needs to be home or nearby. Not necessarily 24/7, but available. The medical team handles the clinical care, but you need a person there to help with activities of daily living and to be present during visits.
Consider your other responsibilities:
Do you have young kids?
Other family members who need care?
A job with no flexibility?
Be honest about your capacity. There’s no shame in saying traditional hospitalization is the better fit for your situation.
How to Access Hospital-at-Home Programs
Most doctors won’t automatically offer this option. You have to ask for it.
When your doctor says you need to be admitted, ask: “Am I eligible for a hospital-at-home program?” If they say they don’t know or haven’t heard of it, ask them to check. Many physicians are still learning about these programs.
Call your insurance company before admission if possible. Verify coverage and get any necessary pre-authorizations. Some programs accept patients directly from the emergency department, which can save you hours in the ER waiting room.
To find hospitals offering hospital-at-home in your area, check the Medicare website’s Hospital Compare tool or call hospitals directly and ask if they participate in hospital-at-home programs.
Questions to Ask Before You Decide
Before you commit to hospital-at-home, get clear answers to these questions.
For your medical team:
“Am I medically stable enough for hospital-at-home?”
“What happens if my condition gets worse at night or on weekends?”
“How quickly can I be transferred to the hospital if needed?”
For the program coordinator:
“How many times per day will someone visit me?”
“Will I see the same nurses and doctors, or will it change?”
“What equipment will be in my home, and who maintains it?”
For your insurance:
“What will my total out-of-pocket cost be?”
“How many days of hospital-at-home care are covered?”
“Is there a limit to how many times I can use this benefit?”
For your family:
“What will I be responsible for as a caregiver?”
“What training will I receive?”
“Who can I call when I’m overwhelmed or unsure?”
Get these answers before you decide. Understanding what you’re signing up for prevents surprises and helps you plan.
Making the Right Choice for Your Family
Hospital-at-home delivers the same quality of clinical care as traditional hospitalization—sometimes better.
But the right choice depends on your medical situation, your home environment, your insurance coverage, and your family’s capacity to help with care.
If George had the option for hospital-at-home care during his treatment, would it have changed the outcome? Probably not. His conditions were too complex and unstable.
But it would have changed our experience. Fewer nights in uncomfortable hospital chairs. More time in our own home. Better sleep for both of us. For the right patient and the right family, those differences matter tremendously.
Know that you have options. Ask questions and advocate for yourself. Don’t assume the hospital is the only place to receive acute care, because it’s not.
If you’re facing hospitalization decisions for yourself or a loved one, share this information with your family. Ask your doctor about hospital-at-home before admission. You might be surprised by what’s possible.
Cryer, L., Shannon, S. B., Van Amsterdam, M., & Leff, B. (2023). Costs for Hospital at Home Patients Were 19 Percent Lower, With Equal or Better Outcomes Compared to Similar Inpatients. Health Affairs, 42(6), 861-868. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22665835/
Edgar, K., Iliffe, S., Doll, H. A., Clarke, M.J., Gonçalves-Bradley, D.C., Wong E., & Shepperd, S. (2024). Admission avoidance hospital at home. Cochrane Database of Systematic Reviews. Mar 5;3(3):CD007491. doi: 10.1002/14651858.CD007491.pub3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/38438116/
Federman, A. D., Soones, T., DeCherrie, L. V., Leff, B., & Siu, A. L. (2018). Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program With Clinical Outcomes and Patient Experiences. JAMA Internal Medicine. Aug 1;178(8):1033-1040. doi: 10.1001/jamainternmed.2018.2562. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29946693/
HAI and Antimicrobial Use Prevalence Surveys. (2024). Centers for Disease Control. Retrieved from https://www.cdc.gov/healthcare-associated-infections/php/haic-eip/antibiotic-use.html
Horwitz, L. I., Moriarty, J. P., Chen, C., et al. (2020). Quality of discharge practices and patient understanding at an academic medical center. JAMA Internal Medicine, 180(8), 1125-1131. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23958851/
Levine, D. M., Ouchi, K., Blanchfield, B., et al. (2023). Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. Annals of Internal Medicine, 176(11), 1455-1466. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31842232/
The House spending bill dropped a bombshell for digital health companies: a proposed 5-year extension for hospital-at-home waivers and 2-year extension for Medicare telehealth flexibilities.
Five years sounds like forever in tech time. But it’s actually a strategic planning nightmare.
Do you build for temporary policy, or bet everything on permanence?
I spent 2 years managing care for my terminally ill husband across 10 different doctors. Every month, he landed back in the hospital with high A1C, low hemoglobin, unbearable pain. If hospital-at-home programs had existed in 2016 with the right technology backing them, he could have avoided dozens of ER visits.
Hospital at home is the future. The question is, what should Series A, B and C health tech founders build in the next 24 months that creates value regardless of what Congress does in 2030?
This isn’t about policy speculation. It’s about strategic planning with incomplete information—which is exactly what building a health tech company requires.
What the Proposed Funding Package Actually Changes
Source: Modern Healthcare
The proposed House spending bill extends two critical Medicare programs—but on very different timelines. Understanding these differences matters if you’re building technology in this space.
The 5-year hospital-at-home timeline explained
The proposed legislation would extend the hospital-at-home waiver through 2030. This isn’t just another short-term patch. Previous extensions gave health systems and tech companies 12-18 months of runway at best.
The current acute hospital care at home initiative lets Medicare pay for hospital-level services delivered in patients’ homes. Without the extension, this program expires in 2025. That’s not enough time to build, validate, and scale meaningful technology infrastructure.
Five years gives you real planning horizon. You can make legitimate platform investments. You can hire engineering teams. You can sign multi-year contracts with health systems.
But—and this is critical—5 years isn’t permanent. It’s a policy experiment with a longer fuse.
What’s still uncertain despite the extension
Even with a 5-year extension, huge questions remain unanswered. CMS hasn’t committed to specific reimbursement rates beyond the waiver period. Will hospital-at-home payments match facility-based acute care, or will they drop to home health rates?
State regulations vary wildly. Some states embrace home-based acute care. Others have licensing requirements that make it nearly impossible. Federal waivers don’t override state-level barriers.
Commercial payers watch Medicare but don’t automatically follow. Your hospital-at-home technology needs Medicare coverage to scale, but commercial adoption determines whether you build a sustainable business.
Technology requirements could shift too. CMS might mandate specific monitoring capabilities, interoperability standards, or quality reporting metrics that don’t exist yet.
Planning for 5 years means planning for uncertainty, not betting on stability.
Most Founders Are Asking the Wrong Question
When the House bill news broke, founder group chats exploded with one question: “Does this mean hospital-at-home is permanent?” That’s the wrong question. It reveals a misunderstanding of how health tech businesses actually succeed or fail.
“Is this permanent?” misses the strategic point
Policy permanence has never guaranteed health tech success. Remote patient monitoring has had Medicare coverage since 2019. Chronic care management codes have existed for years. Both have clear reimbursement pathways. Both have policy stability.
Yet most RPM companies struggle to achieve profitability. Many CCM platforms shut down despite favorable policy.
The real risk isn’t policy reversal. It’s building something nobody needs or can’t afford to operate. Investors price in regulatory risk and execution challenges unique to healthcare.
Your business model needs to create value across multiple scenarios. If hospital-at-home waivers expire in 2030, can your technology pivot to post-acute care? Skilled nursing facilities? Palliative care at home? If you’ve built exclusively for one reimbursement code, you’ve built a fragile company.
The trap of building exclusively for waivers
Remember the telehealth boom of 2020-2021? Some telehealth companies that scaled to thousands of employees during COVID laid off half their staff by 2023.
They weren’t bad companies. They built for a policy moment, not a durable market need.
VCs learned an expensive lesson: waiver-dependent revenue is risky revenue. When I talk to Series B investors now, they ask pointed questions. What percentage of your revenue requires temporary policy? If that policy changes, what’s your Plan B? Can you operate profitably under traditional Medicare rates?
If you can’t answer those questions convincingly, your valuation suffers—even if current policy looks favorable.
What “5 years” really means for your product roadmap
Five years is approximately two technology development cycles for complex healthcare platforms. You can ship an MVP, gather real-world evidence, iterate based on feedback, and launch a mature v2.0 product in that timeframe.
But 5 years isn’t enough time to build everything. You need to prioritize ruthlessly.
Your 24-month window is critical. This is when you validate product-market fit, prove unit economics, and establish your competitive moat. If you can’t demonstrate margin-positive cohorts by month 24, the next 3 years won’t save you.
Years 3 to 5 should assume policy uncertainty, not stability. Build optionality into your architecture. Make sure your platform can serve multiple care settings. Design your data infrastructure to support different payment models.
One scenario planning exercise: map out what your business looks like if hospital-at-home waivers expire in 2030 versus extend another 5 years vs. become permanent. If all three scenarios require fundamentally different strategies, you’re not building a durable company. You’re building a policy bet.
Your 24-Month Minimum Viable Stack
The next 2 years determine everything. You need to build technology that proves value quickly while laying foundation for longer-term expansion. Here’s where to focus your engineering resources and capital.
Core infrastructure that works across reimbursement models
Start with the basics that every home-based care model needs, regardless of how Medicare pays for it.
Remote patient monitoring devices need to integrate seamlessly with your platform. But don’t overbuild here. Start with FDA-cleared devices for vital signs (blood pressure, pulse ox, weight, glucose). Specialty monitoring for rare conditions can wait until you’ve proven your core model works.
Virtual triage and clinical communication platforms matter more than most founders realize. When a patient’s oxygen saturation drops at 3 a.m., someone needs to decide: send an ambulance, dispatch a nurse, or coach the patient through the moment remotely? That decision-making capability is what health systems pay for, not just the device data.
Care orchestration is the unsexy backbone nobody wants to build but everyone needs. Who schedules the nurse visit? Who orders medical supplies? Who coordinates with the patient’s primary care doctor? These back-office functions represent over half of the $1 trillion in annual U.S. healthcare waste. Automating them creates immediate ROI.
EHR integration isn’t optional. Payers demand it. Health systems require it. Your platform needs to pull patient data from Epic, Cerner, and other major EHRs, then push back visit notes, monitoring data, and care plans. Budget 20 to 30% of your engineering resources just for integration work.
Where to invest in AI right now
Source: Health Care Code
Ambient clinical intelligence (ACI) has reached near-universal adoption: 92% of health systems are piloting or deploying AI scribes. These tools improve documentation accuracy, leading to 10 to 15% revenue capture improvement through better coding and billing.
For hospital-at-home programs, this matters enormously. Nurses and paramedics doing home visits often struggle with documentation. They’re managing complex patients in unpredictable environments. AI that turns their verbal notes into structured clinical documentation saves 30 to 45 minutes per visit.
Predictive analytics should focus on preventing acute episodes that require hospitalization. Machine learning models can analyze vital sign trends, medication adherence patterns, and social determinants data to flag patients at risk of decompensation. One health system using predictive monitoring reduced readmissions by 23% in their hospital-at-home cohort—that’s the difference between a margin-positive program and one that loses money on every patient.
Don’t sleep on care coordination automation. If family caregivers spend 15-20 hours per week on caregiving tasks (as CareYaya Health Technologies data shows), your AI should reduce that burden. Automated medication reminders, appointment scheduling, and supply ordering aren’t flashy features, but they’re what caregivers desperately need.
The unsexy AI that saves money: Back-office automation in revenue cycle management, prior authorization, and claims integrity. These AI applications can reach 70-80% profit margins and generate $500K-$1M in annual recurring revenue per full-time employee. That cash flow funds your clinical AI development.
The Margin Math That Actually Matters
Most hospital-at-home programs lose money. Your technology needs to change that equation, or you don’t have a sustainable business.
Why most hospital-at-home programs lose money
Medicare pays $1,000 to $1,500 per day for hospital-at-home. Most programs spend $1,200 to $1,600 per patient daily on nurse visits, supplies, coordination, and tech. They’re underwater from Day 1.
The hidden costs kill you. Logistics and care orchestration require significant labor. Someone schedules visits, manages the supply chain, and coordinates with the patient’s other providers. Traditional staffing models don’t scale—you can’t apply facility-based nursing ratios to home care and expect it to work economically.
Technology that creates work instead of reducing it makes the problem worse. I’ve seen hospital-at-home platforms that require nurses to log into five different systems per visit. The documentation burden exceeds what they’d do in a hospital setting.
How AI makes care at home programs profitable
Revenue cycle optimization through better documentation can improve revenue capture by 10-15%. When a nurse describes a patient’s condition verbally and AI generates accurate, complete clinical notes with proper billing codes, you get paid more for the same work.
Source: MDhelpTEK
Reduced readmissions drive CMS quality bonuses. The hospital-at-home model already shows lower readmission rates than traditional acute care—adding predictive monitoring amplifies that advantage. Every readmission you prevent saves $10,000 to $15,000 in costs and protects against CMS penalties.
Labor cost reduction matters most. AI triage can cut nurse workload by 40%+ in pilot programs. Instead of nurses manually reviewing monitoring data for every patient, AI flags only the patients who need clinical attention. A nurse who previously managed 5-6 hospital-at-home patients can now manage 8 to 10.
The “unsexy” AI that CFOs love but VCs overlook: billing, coding, claims integrity. Administrative AI can reduce operational costs by 30-40%. That’s real margin improvement hitting your income statement immediately.
Proving ROI to your board in the next 6 months
Source: ScribeMD
Your board doesn’t care about utilization growth if you’re losing money on every patient. They care about these metrics:
Cost per episode: What does it actually cost you to manage one hospital-at-home patient from admission to discharge? Track this ruthlessly. Break it down by component: labor, supplies, technology, overhead.
Readmission rates: Hospital-at-home programs typically achieve 8 to 12% 30-day readmission rates versus 15 to 18% for traditional hospital care. If your program doesn’t beat facility-based benchmarks, you have a quality problem.
Patient satisfaction: CMS increasingly ties reimbursement to patient experience scores. Hospital-at-home programs score 15-20 points higher on patient satisfaction versus facility care. That’s your competitive advantage.
Structure pilot programs that generate defensible data. Work with 2 to 3 health systems willing to share financial and outcomes data transparently. You need to prove your technology improves margins, not just clinical outcomes.
The difference between utilization metrics and profitability metrics: lots of patients using your platform means nothing if each one loses money. Focus on contribution margin per patient. When does that number go positive? What’s the path to 40 to 50% gross margins?
The 3 to 5 Year Platform Expansion Strategy
Once you’ve proven your core model works and generates positive margins, you can think bigger. The next phase is about expanding beyond your initial use case.
From point solution to platform
Bessemer’s State of Health AI report describes “supernova” companies that achieve 6-10x growth trajectories by expanding from single point solutions into comprehensive platforms. Ambient scribes became full clinical documentation suites. Prior authorization tools became complete utilization management platforms.
The pattern:
Start with a painful, well-defined problem.
Solve it better than anyone else.
Expand into adjacent workflows that touch the same users.
For hospital-at-home technology, that might mean starting with post-surgical patients recovering at home. Prove you can manage that population safely and profitably. Then expand to heart failure management, COPD exacerbations, cellulitis treatment, chemotherapy administration.
Each expansion requires clinical validation and new reimbursement navigation. But your core technology infrastructure of monitoring, triage, care coordination, documentation stays largely the same.
Value-based care integration timeline
Source: Activated Insights
Hospital-at-home is a wedge into value-based care contracts, not just fee-for-service reimbursement. Accountable Care Organizations (ACOs) and Medicare Advantage plans care deeply about reducing avoidable hospitalizations. If your platform keeps patients out of expensive facility-based care, ACOs will pay for it.
But commercial adoption lags Medicare by 18 to 24 months historically. Don’t expect widespread MA plan adoption until 2027 to 2028, even with favorable hospital-at-home policy.
Self-insured employers represent a faster path to commercial revenue. Large employers pay directly for employee healthcare. When they see data showing hospital-at-home reduces costs by 30-40% versus facility admissions, they’ll write checks. Companies like Cubby, who secured $63 million in Series A funding led by Guggenheim Partners, are targeting this employer market specifically for in-home care solutions.
To position for risk-bearing contracts in years 3 to 5, you need data infrastructure now. Start collecting outcomes data, cost data, and patient experience data from day one. Value-based contracts require you to prove your intervention changes total cost of care—not just that patients like your service.
Decision Framework for Health Tech Boards
If you’re a founder presenting hospital-at-home strategy to your board, or a board member evaluating your company’s approach, here are the right questions to ask.
5 questions your board should ask right now
What percentage of our revenue depends on waiver-specific reimbursement? If it’s above 50%, you have concentration risk. Diversify your payer mix and care settings.
If the waiver expires in 5 years, what’s our Plan B business model? You should have a concrete answer. Can you pivot to post-acute care? Palliative care? Chronic disease management? If the answer is “we’re screwed without waivers,” you’re not building a durable company.
Are we building technology that creates value in multiple care settings? The best health tech platforms work across hospital-at-home, skilled nursing, home health, and ambulatory settings. Flexibility equals durability.
How quickly can we prove margin-positive unit economics? If you can’t show positive contribution margin by month 24, extending the timeline to month 36 won’t magically fix the problem. You have a business model issue, not a scale issue.
What’s our competitive moat if 10 other startups get this same 5-year runway? Policy tailwinds create competition. What’s your defensible advantage? Clinical outcomes data? Payer relationships? Technology that’s genuinely better, not just first to market?
Investor perspective on policy-dependent businesses
Source: WallStreetMojo
VCs underwrite regulatory risk by discounting valuations and requiring faster paths to profitability. A pure software company might get 7-10 years to reach profitability. A health tech company with policy dependency gets 3-5 years maximum.
Some investors love policy tailwinds. They want to ride the wave while it’s building. Others avoid policy-dependent businesses entirely, no matter how attractive the market opportunity looks.
Position your pitch carefully. Are you policy-enabled (taking advantage of favorable reimbursement to scale faster) or policy-dependent (can’t exist without specific waivers)? The former gets funded at reasonable valuations. The latter struggles.
What I Wish Existed When I Was a Caregiver
Let me bring this back to why any of this matters. The technology decisions health tech founders make over the next 24 months will determine what tools families like mine have access to in 2026 and beyond.
The gap between technology capability and real-world reliability
Source: Aptiva Medical
My husband’s Dexcom continuous glucose monitor worked beautifully—when it synced properly. The app sent alerts to my phone whenever his blood sugar went dangerously high or low. That device probably saved his life multiple times.
But it only worked because the technology was reliable:
The sensor stayed attached.
The Bluetooth connection held.
The app didn’t crash.
I’ve seen hospital-at-home platforms that look impressive in demos but break under real caregiver stress. The dashboard shows beautiful data visualizations—but requires three different logins to access. The monitoring devices pair easily in the clinic—but fail when WiFi is weak in rural areas.
Care coordination platforms often assume 24/7 nurse availability. They don’t account for the reality that small hospital-at-home programs can’t staff round-the-clock coverage.
Build for the worst-case scenario, not the ideal one.
Building for the sandwich generation managing multiple conditions
Source: Graying with Grace
My husband had 10 doctors. Ten! A primary care physician, nephrologist, endocrinologist, oncologist, cardiologist, and five other specialists. Your platform needs the capability to handle that complexity.
Nobody coordinated between them. I was the coordination layer. I maintained a spreadsheet with all his medications—drug names, dosages, prescribing doctors, reasons for taking them, refill schedules. The nurses loved my spreadsheet because their systems couldn’t give them the same view.
Insurance coordination created endless frustration. My employer’s insurance was primary while Medicare was secondary. Every billing department called me multiple times to confirm this. I explained the same thing to the hospital billing office, the lab, the imaging center, the pharmacy.
Your hospital-at-home platform should automate this nightmare. Pull medication lists from multiple prescribers. Flag potential drug interactions. Coordinate insurance claims automatically. Don’t make family caregivers become project managers.
Why I care about this 5-year window
Families like mine in 2026 deserve better than what I had in 2016.
The technology exists now, and the clinical models work. The question is implementation and sustainability.
Health tech founders have a moral obligation beyond shareholder returns. Yes, you need to build a profitable business and generate returns for your investors. But you’re also building tools that will serve people during the most vulnerable moments of their lives.
This isn’t about making a quick buck off temporary Medicare waivers then exiting before they expire. It’s about building something that lasts. Something that works. Something that actually helps families manage impossible complexity.
When you’re making technology decisions over the next 24 months, remember: real people will rely on what you build. Build something worthy of that trust.
The Path Forward
The proposed 5-year extension for hospital-at-home waivers isn’t a guarantee. It’s a window.
What you build in the next 24 months determines whether your company survives beyond 2030—regardless of what happens with federal policy.
The smartest founders build technology that creates value across multiple reimbursement scenarios. Focus on margin-positive unit economics. Solve real problems for real families—the kind of problems I faced as a caregiver managing impossible complexity across disconnected systems.
Start with the unsexy AI that makes programs profitable: revenue cycle management, clinical documentation, coding accuracy. These aren’t sexy pitch deck slides, but they generate cash flow.
Build your minimum viable stack around care orchestration and monitoring that works when human resources are constrained. Health systems can’t hire infinite nurses. Your technology needs to make existing staff dramatically more productive.
Structure pilot programs that generate defensible ROI data within 6 months. You need proof points for your next fundraise and for health system expansion.
Stress-test your business model. If hospital-at-home waivers expire in 2030, what’s Plan B? If you don’t have a good answer, you’re building on quicksand.
Five years is enough time to build something durable if you start with the right foundation. It’s not nearly enough time if you’re building for a policy moment instead of a market need.
The families who need hospital-at-home can’t wait for perfect policy clarity. They need technology that works today and keeps working tomorrow. So build for that reality.
Want to discuss your hospital-at-home technology strategy?Connect with me on LinkedIn or explore more health tech analysis at reewrites.com.
References
Bessemer Venture Partners. (2026). State of Health AI 2026. Retrieved from https://www.bvp.com/atlas/state-of-health-ai-2026
Fox, A. (2026). 2026 House spending bill proposes 2-year telehealth and 5-year hospital-at-home waiver extensions. Healthcare IT News. Retrieved from https://www.healthcareitnews.com/news/2026-house-spending-bill-proposes-2-year-telehealth-and-5-year-hospital-home-waiver-extensions
Gardner, S. & Hooper, K. (2026). Health tech panel to reboot after a long break. Politico Pulse. Retrieved from https://www.politico.com/newsletters/politico-pulse/2026/01/21/health-tech-panel-to-reboot-after-a-long-break-00737790
Gonzales, M. (2026). Proposed Funding Package Would Extend Hospital-at-Home Program, Medicare Telehealth Flexibilities. Home Health Care News. Retrieved from https://homehealthcarenews.com/2026/01/proposed-funding-package-would-extend-hospital-at-home-program-medicare-telehealth-flexibilities/
Stock Titan. (2026). Cubby secures $63 million in Series A funding round led by Growth. Retrieved from https://www.stocktitan.net/news/GS/cubby-secures-63-million-in-series-a-funding-round-led-by-growth-ikgye2ab40md.html
Zanchi, M. G. (2026). AI Journal. The “unsexy” revolution within healthcare AI. Retrieved from https://aijourn.com/the-unsexy-revolution-within-healthcare-ai/
I went to the CES 2026’s Digital Health Summit in my new city of Las Vegas, and yes, I oohed and ahhed at the dancing robots and awesome cars and vehicles on display.
But this isn’t your usual “look at this shiny new device” content you’ll see everywhere else about CES. I’m going to share the hard truths that came directly from patients, caregivers, and the organizations who represent them.
Left to right: Jennifer Goldsack, Randall Rutta, Alice Pomponio, Jake Heller, and Yuge Xiao
Product Design Failures Nobody Talks About
Your product design isn’t neutral
Randy Rutta from The National Health Council shared a couple of stories that should make every product team pause:
A major pharma company launched inhalable insulin with all the confidence in the world. The technology was solid, and the marketing was ready, but it flopped completely because they never asked patients if they’d actually use it.
It turns out that people managing diabetes need precision. Something sprayed into your lungs doesn’t feel precise, even if the science says it is. Plus, patients hated the inhaler design itself. Simple focus groups made of their target user base would have caught both issues before millions were spent on development and launch.
Another story hit even harder for me as a Black woman. Randy said a Black woman refused to wear a health monitoring device because it was a bulky black device on her waistband that made her afraid of being stopped by police. Her solution was painfully simple: “If it came in pink, it would have changed everything for me.”
This isn’t about inclusion for inclusion’s sake. It’s about building products that don’t put users at risk. Product design is literally life-or-death for some users.
Randy also mentioned patients with eczema and psoriasis who can’t wear certain devices because they’re too sensitive to materials touching their skin. That’s a deal-breaker for entire patient populations—a product design consideration that could eliminate your addressable market if you ignore it.
Engage patients early or pay later
Alice Pomponio from American Cancer Society’s venture capital arm sees this pattern constantly. You have to think beyond product features to systemic change. She asks founders: “What is not only the short-term product development strategy, but also the longer-term healthcare systemic step change you’re planning to deliver?”
Get patient voices around your cap table. Diversify your board perspective. Even if you have a great management team with good intentions, without a board that supports patient-centered decisions, you’ll lose the opportunity to make cost-effective strategic choices upfront.
It’s cheaper to fix problems during design than during M&A negotiations when your product strategy determines your acquisition price.
Women’s Health Tech Is Broken
Left to right: Sheena Franklin and Maya Friedman
Women are done waiting for tech that works for THEM
Sheena Franklin of K’ept Health interviewed Maya Friedman from Tidepool about how healthtech uses males as the default for AI.
Maya dropped a statistic that should embarrass the entire diabetes tech industry: 70% of women with type 1 diabetes experience insulin sensitivity changes around their menstrual cycles,but there are NO clinical guidelines or algorithms designed for this. Nothing. So women have to manually adjust their diabetes management systems every single month because the technology assumes their bodies work like men’s bodies.
“We need to stop thinking about women’s health as reproductive health. 𝘌𝘷𝘦𝘳𝘺 𝘴𝘪𝘯𝘨𝘭𝘦 𝘩𝘦𝘢𝘭𝘵𝘩𝘤𝘢𝘳𝘦 𝘤𝘰𝘮𝘱𝘢𝘯𝘺 𝘯𝘦𝘦𝘥𝘴 𝘪𝘯𝘧𝘳𝘢𝘴𝘵𝘳𝘶𝘤𝘵𝘶𝘳𝘦 𝘧𝘰𝘳 𝘥𝘢𝘵𝘢 𝘤𝘰𝘭𝘭𝘦𝘤𝘵𝘪𝘰𝘯 𝘢𝘵 𝘵𝘩𝘦 𝘪𝘯𝘵𝘦𝘳𝘴𝘦𝘤𝘵𝘪𝘰𝘯 𝘰𝘧 𝘸𝘰𝘮𝘦𝘯’𝘴 𝘩𝘦𝘢𝘭𝘵𝘩.”
The data gap is massive
Maya Friedman
Maya referenced a project called “The Library of Missing Data Sets,” an art exhibition of hundreds of empty filing cabinets labeled with data sets that don’t exist across different industries. When you look at what’s missing, you see where biases already exist in healthcare.
As AI becomes more prevalent, these data gaps will replicate the same biases we’re trying to fix. That’s why every healthcare technology company needs infrastructure for data collection at the intersection of women’s health. Not as a “nice to have.” As a business requirement.
Tidepool partnered with Oura to build the largest longitudinal data set of diabetes device data combined with biometric data. They’re distributing Oura rings to thousands of users already on the Tidepool platform. The data will include:
Activity tracking
Sleep patterns
Menstrual cycle data
Diabetes device data from the same individuals
Health surveys for contextual data
This is what infrastructure looks like when you take women’s health seriously.
Algorithms need to be smarter
Maya’s immediate priority: building algorithms that aren’t “cycle agnostic.” She wants systems that account for 30-day hormonal patterns, not just 72-hour learning horizons.
“Women are not just tiny men. We have different needs. We need to display different data. We need algorithms that are potentially different for women versus men.” – Maya Friedman, Tidepool
And yes, that means maintaining multiple versions of products.
Yes, it’s more expensive. But it’s also addressing the actual market need instead of pretending half the population doesn’t exist.
It’s not just about menstrual cycles
Maya’s longer-term vision includes AI models that are dynamic across different reproductive milestones. What does an algorithm look like for someone in perimenopause who isn’t having regular periods? What are the learning horizons for that system?
The real moonshot? A fully closed-loop system that accounts for polycystic ovarian syndrome (PCOS), type 1 diabetes, and menstrual cycles without requiring patient interaction at all.
Women need tech that doesn’t make them choose between their health needs and their time.
Accessibility Creates Market Opportunities, Not Limitations
Left to right: Steve Ewell and Peter Kaldes
Peter Kaldes, CEO of Next50 Foundation, delivered a message that should change how every product designer thinks about their addressable market: “Guess what? You still have a point of view over 50. You still have buying power at 60. You can still use your iPhone at 70, and you need really great technology in the 80s and your 90s.”
Most product designers are under 35. Most assume older adults are technology Luddites. The data proves this assumption is completely wrong.
The buying power is enormous
The over-50 population has more buying power than younger generations. Yet, healthtech companies consistently ignore this market or, worse, design products that stigmatize older users. Peter’s frustration was that was crystal-clear:
“I’ve had conversations with some companies like, where are we going to find [older users to test with]? Well, why don’t you try, first of all, start with your company, and second of all, why don’t you start partnering with community organizations that have access to all these people. This is not hard. It’s just getting people out of their comfort zone.” – Peter Kaldes
Dual generational use is smart design
Peter loves technologies that serve multiple generations. If it’s good for older adults, it’s good for everyone. Examples he highlighted:
Hearing technology embedded in glasses to reduce stigma around hearing aids
AI tools that coordinate healthcare appointments along with transportation and nearby housing options
Financial fraud protection that helps older adults without treating them like children
Left to right: Meg Barron, Dominic King and Myechia Minter-Jordan
AARP CEO Myechia Minter-Jordan shared specific examples of products in AARP’s booth that reduce stigma:
Sneakers designed to prevent falls that look like regular athletic shoes (they appear to have laces, though velcro is involved)
Glasses with closed captions for people with hearing impairments
Glasses with hearing aids built into the stems (partnered with Sadika)
“We want to ensure tools don’t further stigmatize us but allow us to live with dignity and age well.” – Myechia Minter-Jordan
The accessibility-to-mainstream pipeline
Left to right: Natalie Zundel, Griffen Stapp, Ryan Easterly and Jack Walters
Griffen Stapp from Ability Central pointed out something product teams consistently miss: Products designed FOR the disability community often get adopted by everyone. But products made for the general population rarely get adapted later.
Examples are everywhere. Curb cuts help wheelchair users, but they also help parents with strollers, delivery workers with hand trucks, and travelers with rolling luggage. Closed captioning helps deaf users, but also people watching videos in noisy environments or practicing language skills.
Build accessibility in from day one, or you’re leaving both impact and revenue on the table.
Adaptable frameworks beat one-size-fits-all
Jack Walters, co-founder of HapWare (winner of the CTA Foundation Innovation Challenge), explained their approach: “Not everyone’s going to have similar care or similar treatments, so you need to be able to adapt to all those different types of needs and necessities in the community.”
They involve the disability community in design from the start, knowing common pain points and anticipating when certain issues might come up. That’s how you build solutions that actually solve problems instead of creating new friction.
Continuous Monitoring Changes Patient Behavior (Without Doctor Visits)
Left to right: Ami Bhatt, Tom Hale, Lucienne Ide and Jack Leach
Tom Hale, CEO of Oura, explained why continuous data matters more than episodic measurements: “Normal isn’t 98.6 degrees. Normal is what’s normal for you, and being able to see that deviation from the baseline allows us to make predictions.”
Oura’s “symptom radar” looks at temperature, heart rate, and other biometrics to predict when you might be getting sick—days before symptoms appear. That’s the intervention window where you can actually change behavior and potentially avoid getting sick entirely.
Patients change behavior when they see their own data
Jake Leach from Dexcom shared a pivotal study from the early days of continuous glucose monitoring. For years, the standard of care for diabetes was finger pricks, which are episodic, painful, and limited.
They ran a study where they put sensors on patients continuously measuring glucose, but they didn’t show patients the data for a week. They just collected baseline information. Then they turned on the display.
Within a day, people started making behavior changes based solely on their own knowledge of their disease and this information they’d never had before. No doctor intervention. No coaching. Just visibility into their own patterns.
The infrastructure problem doctors face
Source:Somebody Digital
Doctors are drowning in data with no infrastructure to process it.
Lucienne Ide from Rimidi left clinical medicine because she was disappointed by how electronic health records (EHRs) were implemented. She expected digital records with clinical decision support layered on top. Instead, she got data dumps with no insights.
As she put it: “I don’t know a single doctor who’s saying, ‘If only I had more data, I would be a better clinician.'”
What doctors need is not more data, but clinical decision support that turns data into actionable insights.
Tom from Oura said one doctor told him: “I want the Oura ring to give me information as if it was written by another doctor. Basically, a consult. Here’s what I know about this patient in clinical terms, and this is the information you need. Everything else, don’t give it to me.”
That’s the responsibility of device companies: Don’t just collect data. Provide insights that save clinicians time and help them make better decisions faster.
Prevention requires behavior change at scale
The consensus was clear: behavior change is what moves the needle on long-term health outcomes. Not medications or procedures. Sleep well, eat well, manage stress, and stay balanced.
Healthcare has failed at behavior change for 75 years because it requires data, user experience (UX), engagement, education, and reinforcement. Doctors don’t have time for that level of ongoing support. Educational content alone doesn’t work because people don’t retain or apply it without reinforcement.
But continuous monitoring combined with AI and smartphone engagement is the combination that finally makes prevention scalable.
As Ami Bhatt from the American College of Cardiology noted, “What has my attention besides my kids? My phone. And I’m looking at that, and that’s the power.”
AI That Actually Helps, Not Hypes
Source:Oxio Health
Dominic King from Microsoft AI cut through all the conference noise:
“The biggest challenge in healthcare today is the mismatch between global demand and constrained supply.” – Dominic King
AI isn’t replacing doctors. It’s closing the gap between what people need and what the healthcare system can deliver.
The future is proactive health companions
5 years ago, AI was good at classification and spotting single problems. Now we have thinking and reasoning models that can pass the same exams physicians take, often at higher rates than human test-takers.
Dominic’s vision for 5 years from now is “A health companion that you wake up and it’s sitting in the background, doing the hard work for you and being more proactive. At the moment, everything is still very reactive.”
This means:
Identifying sleep issues before they compound
Flagging medication adherence problems
Coordinating complex care across multiple providers
Helping people navigate fragmented healthcare systems
Providing specialized opinions even in rural areas
The caregiver opportunity is massive
Myechia shared that one in four Americans are caregivers right now (63 million Americans). If you’re not currently a caregiver or need care yourself, one day you will be.
AI tools can help caregivers:
Communicate with provider teams more effectively
Ensure loved ones are safe at home
Coordinate the “universe of appointments” that comes with aging
Reduce information asymmetry (where only people with medical training understand how systems work)
Dominic emphasized that co-design is critically important. Building WITH users instead of just FOR them avoids the problems we see when products hit the real world.
At Microsoft, they’re seeing 50 to 60 million health questions a day through Copilot. That’s enormous insight into what people actually need help with.
But as he noted, “A lot of founders are young. They don’t have a good idea of what it’s like to be elderly or sick.”
That’s why bringing your end users (patients, clinicians, caregivers) into the development process isn’t optional. It’s the difference between building something that works versus something that sits unused.
The Digital Equity Gap Nobody’s Solving
Left to right: Steve Ewell and Peter Kaldes
Steve Ewell, Executive Director of CTA Foundation, laid out what he calls “the three legs of the stool” for digital equity:
“You need the hardware, you need the broadband access, and then you need the support and education to go along with it. And so often that last one is left off.” – Steve Ewell
That last leg of support and education is where healthcare technology adoption actually lives or dies.
Tech alone isn’t enough
Peter Kaldes from Next50 Foundation added context that should worry anyone in healthtech: nonprofits doing the heavy lifting of digital equity training are facing unprecedented cuts to federal grants.
As Peter noted: “I love going to an Apple Store and seeing these free classes, but you have to find an Apple Store which are not in the neighborhoods that need the help the most.”
The communities that need technology training the most are the least likely to have access to it. And the organizations that bridge that gap are losing funding.
The clinical trial proof
Source: Anatomy.app
Dexcom is running large clinical trials where half the participants come from underserved communities specifically to prove the technology works equally well regardless of service level. They want hard data showing these tools aren’t just for people with resources.
Rimidi partnered with community health centers during COVID to monitor high-risk pregnancies remotely using blood pressure monitors and texting protocols. They tracked engagement by ethnicity and primary language.
There was no difference in engagement. Everyone has a smartphone in that demographic (women of childbearing age), and everyone can text.
This proves that engagement isn’t the problem. The problem is getting access to the infrastructure and training on how to use it.
Mission-aligned capital as the solution
Source: Next50 Foundation
Next50 Foundation is one of the first private foundations to invest 100% of their endowment in aging-focused companies and infrastructure. Not just grant-making, but the other 95% of their capital.
They created an aging investment framework with JP Morgan that looks at four themes:
Health
Social connectivity (including technology)
Economic opportunity (workforce and financial vehicles for longer lives)
Built environment (mobility, housing, accessibility)
As of December, about 75% of their endowment was invested in this framework, and Peter offered a challenge to the investment community:
“What if capital actually had values? Climate investors have successfully made money and helped power cleaner energy. The same can be true for aging. How can we possibly ignore that the globe is aging?” – Peter Kaldes
They also launched a new nonprofit called Leverage focused on advancing policies in Colorado to make aging more affordable—housing, living wages, caregiving resources.
Because you can’t solve systemic problems with technology alone. You need policy change too.
Patient Voices Need to Drive Startup Decisions
Jake Heller from Citizen Health is building AI tools that help patients with rare diseases query their own medical records and advocate for themselves at doctor’s appointments.
His philosophy: “Putting patients in the driver’s seat is one of the biggest opportunities we have right now.”
The journaling and documentation problem
Sometimes when people with rare or complex diseases go to appointments and talk about their concerns, doctors don’t believe them. These patients need help translating their own experience in a way that clinicians will take seriously.
Citizen Health helps patients journal their symptoms and experiences, then presents that data in clinical terms. “Here’s a video of my daughter having this specific type of seizure. Here are the journal entries. Here’s how this has changed over time.”
That’s advocacy powered by data and AI.
The time-to-diagnosis crisis
Randy pointed out that if you have an autoimmune disease, it could be 3, 5, or even 7 years before diagnosis. For healthcare innovation, it can take 7 years just to move something through an FDA process.
Those time frames compound into suffering that’s completely preventable if we had better systems and patient input earlier in development cycles.
Patient organizations are ready to help. They’re trusted by their communities. They can broker relationships, speed recruitment, help startups get from lab to market faster with products that patients will actually use and that payers will actually reimburse.
The startup trap to avoid
Source: National Institute for Health and Care Research (NIHR)
Alice warned about companies that design products, then go looking for users to validate decisions they already made.
That’s backwards. Instead you should:
Find patient voices early.
Put them on advisory boards.
Include them in design sprints.
Listen to their feedback even when it’s uncomfortable or expensive to implement.
The successful companies in her portfolio think about long-term systemic change, not just short-term product development metrics.
What Healthtech Companies Need to Do Differently
The patient community isn’t a barrier to innovation. They’re the key to building products that actually work.
Stop designing in the dark
Source: Patient Better
If you’re building healthtech without continuous patient input, you’re wasting resources. You’ll miss market opportunities. You’ll build products that don’t get used or that put certain populations at risk.
Randy’s message was clear: “Come to us, and we will broker that relationship, because in the end, you’ll be more successful, and the patient community will get a better result.”
Measure what matters
Myechia challenged the AI industry on how they measure success: Don’t count the number of tools or features. Measure whether you’re closing the gap between lifespan and health span.
That gap is currently 13 years, which is the difference between how long people live and how many of those years are healthy years. If your technology doesn’t move that number, what’s the point?
Think systemically, not just tactically
Source: IQ Eye
Every speaker emphasized that technology is only one piece of a larger puzzle. You also need:
Policy changes that support adoption
Payment models that reward prevention
Training infrastructure for underserved communities
Clinical decision support that turns data into insights
Algorithms that account for biological differences across populations
If you’re only focused on your device or platform, you’re missing the bigger picture of how healthcare actually works.
The sales enablement angle
All of these insights about patient needs, accessibility requirements, women’s health gaps, digital equity challenges are the stories your prospects need to hear during long sales cycles.
B2B healthtech sales aren’t quick. You’re selling to health systems, payers, and large provider networks. The buying committees are complex. The evaluation periods stretch for months.
That’s exactly when prospects go cold or arrive at sales calls unprepared.
I create educational email courses to bridge that gap. They keep prospects engaged with the exact kind of patient-centered insights I heard at CES. They position your company as one that understands real-world healthcare challenges, not just technology features.
In 2026 and beyond, healthtech companies that want to win understand their users deeply enough to build products those users will actually want, trust, and use.
The Measurement Challenge
How do you know if you’re succeeding at patient-centered design? Myechia offered a simple test: “What do you want your life to look like at 75?”
You probably want to:
Stay in your home
Feel healthy
Stay empowered
Have information flow easily between you and loved ones
Remain connected to family and physicians
Be safe at home
Engage in daily activities with ease and without pain
Understand your medical information and chronic diseases
Control who has access to your data
Have a care plan you can execute yourself
Receive information you trust and can use readily
If your tech helps people achieve any of those goals, you’re on the right track. If it doesn’t, you need to rethink your approach.
Final Thoughts
CES 2026’s Digital Health Summit covered the hard work of actually listening to patients, caregivers, and the communities being served.
Startups who want to be successful in healthtech aren’t the ones chasing the next funding round or the flashiest AI feature. They’re the ones asking better questions:
Have we talked to patients who look different from our team?
Does our product work for women’s bodies, not just male bodies?
Can older adults use this without feeling stigmatized?
What infrastructure needs to exist beyond our technology?
Are we solving a real problem or just building something technically impressive?
Those questions lead to products that get adopted, outcomes that improve, and companies that actually make a difference. That’s the kind of healthtech worth building.
Every month, someone’s decision to donate blood gave him a little more time, and I’m grateful for that. But blood donation is NOT for everyone.
My late mother learned this the hard way. She faithfully donated with the American Red Cross every 56 days like clockwork, believing she was doing good. And she was, until her then-undiagnosed congestive heart failure (CHF) made each donation increasingly dangerous. The blood loss depleted her already-compromised system, leaving her exhausted for weeks.
Her doctors eventually told her to stop.
January is National Blood Donor Month
One pint of blood can save up to three lives. The American Red Cross says someone in the U.S. needs blood every 2 seconds, but only 3% of eligible Americans (those without contraindications) donate annually.
Source: Stanford Blood Center
Who should NOT donate blood
The FDA and American Red Cross give several contraindications, meaning that if any of the following apply, you should not donate:
Active heart disease or severe cardiovascular conditions
Uncontrolled high blood pressure (over 180/100)
Recent heart attack or stroke
Severe anemia (hemoglobin below 12.5 g/dL for women, 13.0 g/dL for men)
Active cancer or recent cancer treatment
Bleeding disorders or current anticoagulant therapy
Chronic kidney disease
Certain autoimmune conditions during flare-ups
Do you know your blood type?
Only 43% of Americans do, but knowing your blood type can be lifesaving:
In emergencies: Medical teams can administer compatible blood immediately without waiting for typing tests, which can take 45-60 minutes.
For rare blood types: If you’re O-negative (universal donor) or AB-positive (universal plasma donor), you’re critically needed. O-negative makes up only 7% of the population but can be given to anyone.
During pregnancy: Blood type incompatibility between mother and baby can cause serious complications. Knowing your type allows early intervention.
For chronic conditions: People with sickle cell disease, thalassemia, or other conditions requiring frequent transfusions need closely matched blood to prevent complications
If you need surgery: Matching blood in advance reduces transfusion reaction risks and speeds emergency response
According to the National Institutes of Health (NIH), patients who receive a transfusion from an incompatible blood type can experience severe reactions, including kidney failure and death.
The Stanford Blood Center reports that having blood typed and screened in advance can reduce emergency transfusion time by up to 30 minutes, which is critical in traumatic or crisis situations.
If you have cardiovascular issues or other contraindications, prioritize your own health. Other ways to help are by volunteering at blood drives, spreading awareness, and donating money to blood banks.
Regardless of whether you can donate, know your blood type, and the blood type of anyone you care for. It could save your life or help save someone else’s.
organize medical information (including blood type)
coordinate between providers
advocate effectively
References
American Red Cross. (n.d.). Requirements by Donation Type. Retrieved from https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements.html
U.S. Food and Drug Administration. (2023). Compliance Policy Regarding Blood and Blood Component Donation Suitability, Donor Eligibility and Source Plasma Quarantine Hold Requirements. Retrieved from https://www.fda.gov/regulatory-information/search-fda-guidance-documents/compliance-policy-regarding-blood-and-blood-component-donation-suitability-donor-eligibility-and
National Heart, Lung, and Blood Institute. (2025). Donate Blood. Save Lives. Retrieved from https://www.nhlbi.nih.gov/education/blood/donation
Stanford Blood Center. (2024). Blood Type Compatibility. Retrieved from https://stanfordbloodcenter.org/donate-blood/blood-donation-facts/blood-types/
Your healthtech startup just nailed the product demo. The prospect loved your solution. They asked great questions. Everyone smiled and nodded. And then… silence.
Your prospect isn’t saying no, but they’re not saying yes either. They’ve gone dark. And while you wait, your pipeline stalls, your forecast becomes fiction, and your investors start asking uncomfortable questions.
If that’s typical for your startup, then you’re stuck in what sales leaders call the “dead zone.” It’s that frustrating gap between an enthusiastic demo and an actual decision.
This isn’t a follow-up problem; it’s a deal architecture problem. Let’s see why it happens, and how to fix it.
The dead zone doesn’t happen by accident. It’s built into how healthcare organizations buy technology. Understanding these forces helps you design a process that works with them, not against them.
Your champion can’t move forward alone, even if they love your product. Here’s who typically needs to sign off:
Clinical staff validate workflow impact and patient safety concerns
IT teams assess technical integration and infrastructure requirements
Compliance officers review HIPAA and regulatory implications
Finance departments demand ROI justification and budget alignment
C-suite executives evaluate strategic fit and organizational priorities
Decision-making authority is unclear or distributed across multiple departments, which means your single point of contact has less power than you think.
Procurement cycles that stretch for months
Source: CorporateVision
Healthcare organizations operate on budget cycles that don’t match your timeline. As it stands, large purchase approvals require alignment from at least 5 key stakeholders, and 86% of B2B purchases stall during the buying process. The typical B2B buying cycle spans 11.5 months.
The challenges you’ll face during this timeline:
The average healthtech sales cycle runs 9-18 months
Most delays occur post-demo rather than pre-demo
Budget freezes and reallocation priorities create unexpected stops
Capital requests often have to wait until the next quarterly meeting or annual board meeting
Even if you’re ready to close, your prospect won’t see their available budget until Q3.
Risk aversion in healthcare organizations
Healthcare buyers face career risk when new technology fails. HIPAA compliance, patient safety, and data security create legitimate concerns that go beyond typical B2B software fears.
Case studies from similar healthcare organizations
Reference calls with peers in comparable settings
Security audits and compliance documentation
Implementation plans that minimize disruption
The status quo feels safer than change, even when change would help.
Why Your Champion Goes Silent After the Demo
You didn’t lose the deal because of your product. You lost it because your champion hit an internal wall they couldn’t climb alone.
They lack internal buy-in from key stakeholders
Maybe your champion didn’t build a consensus before bringing you in. They saw your solution, got excited, and scheduled a demo without socializing the idea internally first. Other departments see the demo as “their project,” not a company priority.
This happens when:
Clinical staff, IT teams, or compliance officers weren’t in the room during your presentation
Your champion is now selling internally without your help or materials
They’re trying to recreate your demo in conference rooms and Slack channels
They’re failing because they don’t have your expertise or your sales enablement resources
It could be that your champion is fighting battles you don’t even know about.
They can’t build a business case
Rejected healthtech proposals fail due to “insufficient financial justification” rather than product concerns. So it’s also possible your ROI explanation doesn’t translate into their internal budget language.
Your champion needs specific numbers, like:
Cost savings expressed in their organization’s actual spend
Efficiency gains measured by hours saved or capacity increased
Revenue impact tied to reimbursement or patient volume
Risk reduction quantified in dollars, not just qualitative benefits
Your champion doesn’t know how to quantify the problem you solve in the terms their CFO cares about.
Most healthcare leaders consider ROI as the primary factor in their purchasing decisions. Finance teams shoot down proposals that lack concrete financial justification, and generic industry benchmarks won’t cut it.
They’re overwhelmed by next steps
If you didn’t create a mutual action plan after the demo, then your champion doesn’t know what to do next, or who needs to do it. Their path from demo to contract feels unclear and complicated.
The questions swirling in their head:
Do they need security documentation first?
Should they schedule an IT review?
Who builds the business case?
What approvals are required and in what order?
Then, other priorities compete for their attention, and your deal slides down the list.
Mistakes That Send Deals to the Dead Zone
Most healthtech sales teams create their own dead zone problems. See if any of these mistakes seem familiar.
Not mapping the decision process before the demo
Most salespeople demo before understanding the approval process. You don’t know who makes the final call or controls the budget. Critical stakeholders aren’t identified until after you’ve presented, which means you built your pitch for the wrong audience.
Treating demos as closing events instead of middle steps
This is when the demo becomes your peak moment instead of a milestone. You celebrate interest without securing commitment to next actions.
Your prospect leaves with information but no obligations. There’s no scheduled follow-up, no agreed-upon timeline, no documented next steps.
Four things you’re missing are:
Commitment to specific next actions with dates
Agreement on who needs to be involved going forward
Documentation of the decision process and timeline
Accountability for both your tasks and theirs
You haven’t earned the right to ask for specific commitments yet, so you don’t. Then you wonder why they ghosted you.
Failing to create urgency around the problem
When your demo focuses on features instead of the cost of inaction, prospects feel no sense of urgency.
Prospects don’t feel pressure to change their current situation because you haven’t quantified what staying with the status quo costs them in dollars, patient outcomes, staff burnout, or a competitive disadvantage.
There’s no compelling event driving a decision timeline. When everything is important, nothing is urgent.
How to Keep Deals Moving Through the Decision Phase
You can’t eliminate the dead zone entirely, but you can shrink it. Here’s your playbook.
Build a mutual action plan before you demo
Document every step from demo to signature with specific dates. Then get your prospect to commit to milestones in writing, even if it’s just a shared Google Doc.
Your mutual action plan should include:
Specific dates for each milestone, not vague timeframes
Names who will own every action item on both sides
Dependencies that could block progress
Decision criteria that need to be met at each stage
Map the buying committee during discovery, not after the demo. Ask questions like “Who else needs to be involved in this decision?” and “What does your typical approval process look like?”
To engage stakeholders effectively, you should:
Identify everyone who has input or veto power.
Understand their concerns and what success looks like for each person.
Schedule separate sessions for different stakeholder groups.
Tailor your messaging to what each group cares about.
Create sales enablement materials your champion can share internally.
Make the business case impossible to ignore
Translate your value into their specific metrics and KPIs. Build ROI models with their actual data, not generic industry averages. If they’re losing $200K annually to manual workflows, show them that number with their own figures.
Your business case should include:
Current state costs using their actual numbers
Future state benefits tied to their strategic goals
The cost of delay expressed in quarterly or monthly terms
The payback period and total ROI over 3-5 years
Risk mitigation value they can’t get from their current approach
Show the cost of delay in concrete terms they can present to leadership: “Every quarter you wait costs $50K in lost efficiency.” That’ll get their attention!
Schedule the next meeting before you leave the current one
Never end a conversation without making the next appointment.
Don’t say “I’ll follow up next week.” Say “Let’s get 30 minutes on the calendar for Thursday at 2 pm to review the security documentation with your IT director.”
To make every next step count:
Be specific about the date, time, and attendees
State the purpose and agenda for the meeting
Include the right stakeholders from the start
Confirm attendance from all required participants
Send the invite before you end the call or leave the room
Use calendar invites to maintain theircommitment.
The Five Warning Signs Your Deal Is Entering the Dead Zone
If you catch these signals early, you can still save the deal.
Your champion stops responding within 48 hours
Response times stretch from hours to days to weeks. Messages shift from specific (“Can you send the HIPAA compliance documentation?”) to vague (“Let me check with my team”). Your champion cancels meetings or suggests “checking back later” without offering alternative dates.
You’re chasing instead of collaborating.
New stakeholders appear who weren’t in your process
Someone from IT, legal, or procurement suddenly has questions. These stakeholders don’t have context from earlier conversations, so they’re starting from zero.
Watch for these red flags:
They raise objections you thought you’d already addressed
Your champion can’t or won’t facilitate introductions to these people
You’re answering basic questions that should’ve been covered weeks ago
Each new stakeholder brings a completely different set of concerns
This means your champion isn’t in control of the internal process.
The timeline becomes unclear
What this looks like:
Dates you agreed to slip without explanation.
Your prospect stops committing to specific next steps, replacing “We’ll have a decision by March 15” with “We’re still working through some things.”
Budget approval timelines shift or become uncertain.
Urgency disappears from the conversation.
When timelines evaporate, so do deals. Time kills deals.
Requests for information become repetitive or circular
Answering the same questions multiple times for different people is a waste of time and energy. When different stakeholders ask for information you’ve already provided, or your champion isn’t distributing materials internally, it quickly gets chaotic:
Your prospect can’t consolidate feedback from their internal team.
Everyone’s operating on their own without any team coordination.
The goalposts keep moving with new requirements.
No one seems to remember what was already agreed upon.
This signals a breakdown in your champion’s internal process.
Your champion asks you to “be patient” or “give them time”
Generic stall language replaces specific action commitments.
Your champion can’t articulate what’s happening internally or who’s holding up the process. They avoid discussing the actual decision-making process when you ask direct questions. You sense they’re hoping you’ll go away.
This isn’t patience—it’s avoidance.
What to Do When a Deal Goes Dark
Don’t give up—try these interventions first.
Use a breakup email to force a response
Write a professional note acknowledging the silence: “I haven’t heard back after my last three emails. I’m guessing this isn’t a priority right now.”
Give your prospect permission to say no: “If you’ve decided to pause or go another direction, that’s completely fine. Just let me know.”
Your breakup email should:
Acknowledge the silence without being passive-aggressive.
Give permission to say no to make responding easy.
Create urgency by suggesting you’re moving on.
Include a simple yes/no question they can answer quickly.
Reach out to people who were in earlier meetings, and provide value:
Share a relevant case study, industry report, or article that addresses a concern they raised.
Ask if there’s anything blocking progress from their perspective: “I wanted to check in—is there anything on our end that would help move this forward?”
Position yourself as a resource, not a pest.
Offer a smaller commitment to restart momentum
Suggest a pilot program or limited trial that reduces risk. Propose a workshop or assessment instead of a full implementation: “What if we started with a 30-day pilot in one department?”
Ways to reduce the ask:
Pilot programs in a single department or location
Proof of concept projects with limited scope
Assessment or audit services to quantify the problem
Executive workshop to build internal alignment
Build a Sales Process That Prevents the Dead Zone
The best way to handle the dead zone is to not enter it in the first place.
Run a sales audit to find where deals stall
Review your last 20 lost opportunities to identify patterns. Track which stage most deals go dark (Hint: it’s probably post-demo). Calculate your conversion rate from demo to next step, from next step to proposal, and from proposal to close.
Your sales audit should examine:
Conversion rates between each stage of your pipeline
Average time spent in each stage before progression or loss
Common objections that appear in lost deal notes
Stakeholder gaps where key decision-makers weren’t engaged
Process breakdowns where your team didn’t follow best practices
Interview former prospects who ghosted you to understand why. Ask questions like “What happened internally after our demo?” and “What would have made it easier to move forward?”
Document the gaps between your process and their buying process.
Day 2: Average time in each stage to spot bottlenecks
Day 3: Review lost deal notes for patterns
Day 4: Interview your team about common objections and stalls
Day 5: Prioritized list of fixes based on impact and effort
Create a post-demo playbook for your team
Script the conversation that happens at the end of every demo. Your reps should never let a prospect leave without completing three tasks: scheduling the next meeting, documenting the mutual action plan, and identifying any stakeholders who need to be involved.
Your playbook should include:
Scripts for transitioning from demo to next steps
Templates for mutual action plans and business cases
Stakeholder-specific materials for champions to use internally
Objection handling guides for common post-demo concerns
Role-playing exercises to practice the post-demo conversation
Implement a deal review cadence for stuck opportunities
Meet weekly to discuss deals that haven’t progressed in 10+ days. Bring fresh perspectives to stalled conversations—sometimes another team member sees an angle you missed.
Your deal review process should:
Identify stuck deals based on time since last progression
Diagnose the blocker using the warning signs framework
Develop intervention strategies specific to each situation
Assign ownership for executing the intervention
Follow up within 48 hours to measure results
The Dead Zone Doesn’t Have to Win
The dead zone kills more healthtech deals than pricing, competition, or product gaps. You can’t control healthcare buying cycles, but you can control your process”
Start by running a sales audit to find where your deals actually stall.
Map the decision process before you demo, not after.
Build mutual action plans that turn prospects into partners.
Create urgency around the problem, not just excitement about your solution.
Your demo isn’t the finish line; it’s like getting to mile marker 5 in a marathon. The companies that win in healthtech sales know this, and design their process to bridge the gap between demo and decision.
They make it easy for champions to sell internally, and they never let a deal go dark without a fight.
Imagine that one of your potential or current customers is desperately seeking help, and they land on your website. They find your FAQ page, scroll through dozens of entries about your “mission” and “values,” but can’t find the simple answer they need.
They leave and go on to the next website, still searching for answers. You’ve lost them.
The problem isn’t that FAQs don’t work—it’s that most companies build them backwards. They write questions they want to answer instead of questions customers actually ask. This guide shows you how to flip that script. You’ll learn exactly how to find the real questions your users are asking, organize them so people can actually find answers, and create an FAQ section that builds trust instead of frustration.
Most companies treat their FAQ section as a place to dump corporate talking points. They use it to explain policies that benefit the company, not to solve customer problems.
If your FAQ page isn’t helping people, it’s a waste of time.
The disconnect between company priorities and user needs
When you write “What makes our company special?” instead of “How do I return a damaged item?”, you’re wasting everyone’s time. Customers don’t care about your award-winning customer service philosophy when they’re trying to figure out shipping costs.
But when your FAQ is full of vague answers and marketing speak, you force people to contact support anyway. That ineffective FAQ page increases your costs and frustrates your customers.
The cost of poor FAQs
Poor FAQs have real business consequences. They lead to:
Increased support tickets and calls for simple questions you could’ve answered online
Cart abandonment when shoppers can’t find basic information
Lost sales because customers give up and go to competitors
Damaged credibility when your “Help” section doesn’t actually help
Instead, of thinking about what you want to say, start thinking about what your customers need to know.
How to Find The Questions Your Customers Ask
You don’t need to guess what questions to answer. Your customers are already telling you—you just need to listen. Here’s where to find the real questions that matter.
Mine your customer support tickets and email inquiries
Your support inbox is a goldmine. Every ticket represents a question your FAQ should’ve answered but didn’t.
Start by reviewing your last 200 support tickets or inquiries. Look for patterns. You’ll notice the same questions appearing again and again.
Pay attention to the exact words customers use. If 10 people ask “Can I change my order after I place it?” that’s an FAQ question.
Check your live chat transcripts
Live chat shows you what confuses people in real-time. Unlike support tickets, chat transcripts capture the moment of confusion. You can see exactly where customers get stuck in their journey.
Review 50 to 100 recent chat sessions or comments. Which pages do people visit where questions come up? If everyone chatting from your pricing page asks the same question, you need to add that to your FAQ.
Analyze your website search data
Your internal search bar tells you what people can’t find on their own. Log into your website analytics and pull up your site search reports.
The top 20 search terms reveal your biggest content gaps. If “refund policy” appears 500 times a month in your search data, but you’ve buried that information three clicks deep, you’ve found an FAQ question.
People ask questions on social media because they couldn’t find answers on your website. Check your:
Facebook and Instagram comments on your posts
Twitter mentions and DMs
LinkedIn company page comments
YouTube video comments if you have a channel
You’ll find questions you never thought to address. Social media gives you unfiltered feedback about what confuses people or what they wish you’d explain better.
Read your product and service reviews
Reviews aren’t just about ratings—they’re full of questions and confusion. Browse your reviews on your site, Amazon, Google, TrustPilot, Yelp, or industry-specific platforms.
Look for reviews that mention confusion or difficulty. Comments like “I wish I’d known this before buying” or “It would be helpful if they explained…” show you missing FAQ topics.
Your front-line teams hear everything. They know which questions come up daily and which explanations customers struggle to understand.
Schedule monthly FAQ check-ins with these teams. Ask: “What questions did you answer this week that we should add to the FAQ?” They’ll give you specific, actionable insights you can’t get from data alone.
The Best Research Methods to Find User Intent in Searches
Finding questions is step one. You need to understand why people ask them and how they think about their problems.
Set up a tagging system
Create a simple system to categorize every support inquiry. You can use tags like:
Update it weekly. Questions that appear 10+ times are high priority for your FAQ. Questions that appear once might not need to be there at all.
Use keyword research tools
Tools like Google’s “People Also Ask” feature, Answer the Public, and your SEO platform show you what people search for online.
Enter your main topic and see what questions Google suggests. If Google thinks these questions are important enough to show in search results, they should probably be in your FAQ. Research shows “People Also Ask” (PAA) boxes appear in 85% of Google search results, making them a reliable indicator of common questions.
Run card sorting exercises with real users
Source: Interaction Design
Card sorting helps you understand how people naturally group information.
Test with 5 to 10 people from your target audience. Give your research participants 20 to 30 FAQ topics written on cards (physical or digital). Ask them to organize the cards into groups that make sense to them.
This is a great way to learn how they think about your content. Maybe they group all payment questions together, while you had them scattered across “Billing,” “Subscriptions,” and “Refunds.” Use their mental model to design the structure of your FAQs.
Conduct user testing on your current FAQ
Watch real people try to use your existing FAQ. Give them specific tasks like “Find out how to cancel your subscription” and observe where they struggle.
Finding the right questions matters, but your answers need to deliver. Here’s how to write FAQ answers that people can actually use.
Use your customer’s language
Write like your customers talk, not like your legal team talks. If customers say “cancel,” don’t write “terminate your subscription agreement.” If they say “broken,” don’t write “manufacturing defect.”
Don’t make people read three paragraphs to find what they need. Start with the answer, then add details if needed.
Poor: “Our company values customer satisfaction. We’ve designed our return policy with flexibility in mind. After careful consideration of industry standards…”
Way Better: “You can return items within 30 days for a full refund. Keep your receipt and original packaging.”
The second version respects your reader’s time.
Keep answers scannable
Source: Ahrefs
Most people scan—they don’t read word by word. Make scanning easy with:
Short paragraphs (2-3 sentences max)
Bullet points for lists or steps
Bold text for key information
Clear headers that describe what’s in each section
Abstract answers create more confusion. Concrete examples make everything clear.
Instead of: “Shipping times vary based on your location.”
Write: “Shipping takes 2-3 business days within the continental US, 5 to 7 days to Alaska and Hawaii, and 7 to 10 days internationally.”
Numbers, timeframes, and specifics eliminate ambiguity.
Add visuals when they help
Some answers work better with screenshots, diagrams, or short videos. If you’re explaining how to use a feature, a 30-second video beats 300 words of text.
But only add visuals when they actually clarify something. Don’t add images just for decoration. Every element should have a purpose.
Smart Ways To Organize Your FAQ Architecture
Source: ResearchGate
Even perfect answers won’t help if people can’t find them. Your FAQ structure determines whether users get help or give up.
Group by the customer journey stage
Source: Funnelytics
Organize questions around where customers are in their relationship with you.
Before buying:
Pricing and payment options
Product features and specifications
Shipping and delivery
During use:
Getting started guides
Common tasks and how-tos
Tips for better results
When there’s a problem:
Troubleshooting steps
Returns and refunds
Contacting support
This structure matches how people think. A potential customer doesn’t want to wade through troubleshooting questions. (Someone with a broken product doesn’t care about your payment plans.)
Create clear categories with descriptive names
Your category names should be obvious. Don’t get creative here—clear beats clever.
Your FAQ search needs to be smart. But building a fancy search function might not be realistic or necessary.
If you have fewer than 25 FAQ questions, you probably don’t need search at all. A simple, well-organized page with clear categories and a table of contents at the top works fine. Users can scan and find what they need quickly.
If you’re using a website builder like Squarespace, Wix, or WordPress, many come with basic built-in search. Turn it on if you have it, because even simple search is better than none. Most platforms include this feature in their standard plans.
For growing solopreneurs with 50+ FAQs, consider these free options:
Use your platform’s native search and make sure your FAQ titles include the exact words customers use
Add a “jump to section” table of contents at the top of your FAQ page with clickable links (just like this article)
Try Algolia’s free tier (up to 10,000 searches per month) if you need something more powerful
Use Google Custom Search Engine (free with ads, or $5/month without ads)
Don’t stress about having the “perfect” search experience. A well-organized FAQ with clear headings and a ctrl+F-friendly structure beats a poorly organized FAQ with expensive search any day.
Show your most popular questions first
Don’t make everyone scroll to find common questions. Put your top 5 to 10 questions right at the top of your FAQ page where everyone can see them.
Update this list quarterly based on your analytics. The questions people viewed most last month should be prominently displayed.
Technical SEO For Your FAQ Content
Good FAQs help customers. SEO-optimized FAQs help customers find you in the first place.
Source: RankMath
Use FAQ schema markup
Schema markup is code that tells Google “this is a question and answer.” It can make your FAQs appear in search results as rich snippets; those expanded results that show the question and answer right on the Google search page.
Pages with FAQ schema have been shown to get more clicks than regular listings. It’s worth the technical effort or asking your developer to add it.
Structure each question as a heading
Use H2 or H3 (subheading) tags for your questions (the heading above is an H3). This helps screen readers, improves accessibility, and tells search engines these are important questions.
Don’t just bold your questions, use proper heading tags. Search engines pay attention to headings when deciding what your page is about.
Target long-tail keywords
Long-tail keywords are specific phrases people actually search for. “How do I track my order?” is a long-tail keyword. “Tracking” is not.
Write your FAQ questions the way people search. Google Search Console shows you the exact phrases people use to find your site. Use those phrases as your FAQ questions when relevant.
Your FAQ isn’t a one-and-done project. It needs regular care to stay useful.
Review quarterly
Set a reminder to review your FAQ every three months. Check that:
All information is still accurate
Links still work
Product features haven’t changed
Policies are up to date
Nothing destroys trust like outdated information. If your FAQ says “we ship within 24 hours” but you changed that policy six months ago, you’re creating problems instead of solving them.
Source: Powerslides
Add new questions as they emerge
When you get the same question multiple times, add it to your FAQ page ASAP. Keep your FAQ fresh and responsive to current customer needs.
Archive outdated questions
If a question no longer applies, remove it. Don’t leave it there with a note saying “this feature no longer exists.”
Don’t neglect to update your FAQs because old, irrelevant questions make your FAQ harder to navigate. They waste your users’ time sorting through them, and make your business look sloppy.
Track your FAQ metrics
Use analytics to monitor:
Which FAQ questions get the most views
How long people spend on FAQ pages
Whether people contact support after viewing an FAQ
Search terms that lead people to your FAQ
If a question gets 1,000 views a month but your bounce rate is 90%, that answer isn’t working. Test a clearer version and see if engagement improves.
Common FAQ Mistakes To Avoid
Even with good intentions, it’s easy to mess up your FAQ. Watch out for these common problems.
Source: RCR Financial
Writing in corporate voice
Your FAQ should sound like a helpful friend, not a legal document. Compare these examples:
Corporate: “Upon receipt of your inquiry, our customer success team will endeavor to provide resolution within the timeframe specified in our service level agreement.”
Helpful: “We’ll respond to your message within 24 hours on business days.”
The second version is easier to understand and gets to the point.
Give people the core answer fast, then add details for those who need them.
Using your FAQ as a dumping ground
Just because someone asked a question once doesn’t mean it needs to be in your FAQ. Focus on questions that come up repeatedly. A FAQ with 200 questions helps nobody—it’s too overwhelming to use.
Your FAQ page should be one of your hardest-working assets. When built with real user questions and organized around how people actually think, it reduces support costs, builds trust, and helps customers succeed faster.
The key is to stop guessing what people want to know and start listening to what they’re already asking.
Your customers are searching for answers right now. Give them a FAQ page that actually delivers. Your support team will thank you, your customers will trust you more, and your business will benefit from the reduced friction.
The best FAQ pages don’t feel like FAQs at all—they feel like a helpful friend who knows exactly what you need.
The intersection of chronic illness management and in-home caregiving presents unique challenges in healthcare. Through a compelling blend of personal storytelling and empirical data, this article illuminates the often-overlooked daily struggles of working caregivers.
I examine how emerging technologies and care models such as remote patient monitoring and care-at-home programs can transform the caregiving experience, offering valuable perspectives for healthcare providers and health plans seeking to integrate effective care solutions.
I married a man just two months after we met, because if I didn’t, I knew he was going to die.
I met George on a dating site in March 2016 as “PuertoRicanPapi.” During our first phone conversation, I learned he had been diagnosed with Stage 4 end-stage renal disease (ESRD) and only had 18 months to live. He needed to start dialysis, but his ACA health plan wouldn’t cover it.
The Global Burden of Disease ranks chronic kidney disease (CKD) among the top 20 causes of death (Ibrahim et al., 2022). CKD is regarded as a high-stress illness due to the chronicity of the disease and the long-term treatment required. ESRD is the last stage of CKD, often caused by diabetes mellitus.
That’s a heavy thing to hear from anyone. But there was something about him that wouldn’t let me leave him alone.
The Downward Spiral
The Diabetes Domino Effect
George was a 40-year-old Puerto Rican man with diabetes, neuropathy, and ESRD. The following year, he developed non-Hodgkins lymphoma (NHL) and eventually sepsis. Over the course of our 2 years together, I coordinated his care among 10 doctors (primary care and various specialists).
His diabetes diagnosis is unclear, as some of his doctors mentioned Type 1 and others said it was Type 2. But from what I understand, before we met, a clinic had prescribed him insulin pills when he actually needed the insulin pens.
That’s a heavy thing to hear from anyone. But there was something about him that wouldn’t let me leave him alone.
Peritoneal Dialysis and the Hospital Revolving Door
That fall, George got surgery to implant a port into his belly, and then we started peritoneal dialysis (PD) from home. I set up the machine and ran it for him every night as I was taught by his nephrology team. But every month he went to the hospital because:
A1C was high,
His hemoglobin count was low (especially after chemotherapy) and he needed a blood transfusion, or
He was in pain.
He didn’t like being there because no one would let him rest, nutritionists came in to tell him how to eat properly for a diabetic and renal diet (and often those menus were contradictory), and other clinicians would come in and ask the same questions every time. I occasionally stayed overnight with him if my daughter was accounted for.
Weekends were the worst, because when he was having intense pain, he had to visit the ER for relief, of course waiting all day for his name to be called.
We also enrolled in a kidney transplant program at Emory Hospital in Atlanta, GA. Although I wasn’t a match to be a kidney donor for George, I was eligible to be in an exchange program with someone else, and they could provide a matching kidney for George. Unfortunately, the next setback negated these efforts.
Developing Cancer
George saw the dentist for pain in his mouth a few times in the fall of 2016 and spring of 2017. The dentist found an abnormality in his mouth that kept coming back.
During that last visit, George went to the hospital, they tested it and it was cancer–Non-Hodgkins Lymphoma (NHL).
He started chemotherapy later that month. His beautiful hair started shedding on the pillowcase the next day, and mourning began.
Losing his Leg
A few months later, George fell in our bathroom upstairs while I was in New York at my grandmother’s funeral. His teenage daughter was home, but downstairs. She called me two days later to tell me that he fell, and that his foot was black.
Source: Alltech Prosthetics
Type 2 diabetes often causes complications that can lead to lower limb amputation (Costa et al., 2020), and unfortunately, this is when George’s health took a turn for the worse. We went to a specialist after I got back from New York, who confirmed his left foot was broken and would probably never heal correctly, and recommended a below-the-knee amputation. George was devastated, but went through with it.
Afterward, he could still drive with his right foot, and he decided to buy a large SUV. I assisted him with getting in and out of the truck with his new wheelchair. However, we no longer slept together, because our bedroom was upstairs. He stayed on the couch for a few months until we got a hospital bed placed in the living room.
Losing Hope
Even though he was taking several prescribed high-dose narcotics, they didn’t have much effect in pill or patch form. Only medicines administered by IV quelled his suffering.
I always felt like I had to be strong, but I was at my wits end, suffering silently beside him. The last straw was when he developed gangrene on his genitalia, and it wasn’t curable. His pain intensified, and I advocated for him tirelessly by calling doctors, and researching information, but it was impossible to get pain management from any doctor in our city, so he suffered needlessly.
Multiple calls to his nephrologist and primary care doctor were never addressed, so I believed that palliative care was the only thing that would make him comfortable. In January 2018, I admitted him to hospice care, where he died a couple months later. I didn’t receive follow-up counseling afterward, but I met with my therapist a few more times until I moved out of state and back near my family to grieve.
Looking Back
The single most important thing missing from my experience that would have made things easier is access to support, which I describe in the following DECAF section.
I balanced parenting and school functions with spousal caregiving, administrative duties like tracking his medications, scheduling new appointments and conferring with health insurers, transporting my husband to multiple appointments, household responsibilities, and my full-time work as a technical writer with a Fortune 50 corporation. And I didn’t receive support from providers after his death, except for a newsletter from the hospice team every few months until a year passed.
I could have used an assistant for appointment scheduling and insurance coordination. A home health aide at flexible times to help with toileting and other ADL tasks.
Effects of In-Home Caregiving by Working Adults
During the pandemic, parents of school-aged children learned what it’s like to try balancing the role of teaching them while also managing their own work and household responsibilities. In-home caregiving was similar in my experience-–I had to juggle my work duties working from home with caring for my husband, and it wasn’t easy.
A study of the estimated 8.8 million employed family caregivers found that nearly 1 in 4 (23.3%) reported either absenteeism or presenteeism over a 1-month period due to caregiving (Fayete et al., 2023). Among those affected, caregiving reduced work productivity by one-third on average—or an estimated $5,600 per employee when annualized across all employed caregivers—primarily because of reduced performance while present at work. Productivity loss was higher among caregivers of older adults with significant care needs and varied according to sociodemographic characteristics and caregiver supports.
CareYaya Health Technologies’ data shows that caregivers spend an average of 15 to 20 hours per week on caregiving tasks. “It’s super hard to draw the line between when you’re working and when you’re caregiving when you’re WFH,” says CEO Neal K. Shah.
“70% of caregivers worldwide are women, and their average age is 49,” says Cheryl Field, MSN, RN. “So if you think about the multiple roles that a 49-year-old woman is playing between their own children, their career, their parents, their partner and the biological changes that come with menopause, you can see that caregivers are in a particularly pressure-filled time of their life. Any means by which they can reduce some of these stressors is significant.”
Stress from Multitasking
Source: Position is Everything
Caregiving influences several dimensions of the caregiver’s life, such as physical (e.g., physical health deterioration), psychological (e.g., anxiety and traumatic stress), family (e.g., roles and routines) and social (e.g., leisure time and social life) (Costa et al., 2020). Caregivers under stress report high levels of depressive symptoms, anxiety, high use of psychotropic drugs, low satisfaction with life, several symptoms related to psychological stress, and low subjective health.
“In-home caregiving lends itself to both more and less stress for the caregivers,” notes Dr. Caryn McAllister of High Quality Therapy. “Caregivers who work from home can juggle responsibilities needed during the day with work, and flexibility with respect to hours can allow people to contact medical professionals, organize schedules, and ensure their loved one eats, goes to the bathroom and takes medicines on time. The extra stress can come when people don’t have the ability to transition between work and home life. People often find they can leave work at work when they go home, but caregivers who work from home just don’t get that break. Ever! It takes organization and discipline to make it work.”
Wil Thomas, Editor of the Senior Bulletin, mentions a reader named John who echoes these sentiments. John has a full-time job while taking care of his elderly mother. “It’s like having two full-time jobs,” he says. “I’m constantly juggling meetings and her medical appointments, and it’s exhausting.”
Field understands this, too. As a former chief product officer who had a senior living with her in a multigenerational setting. She highlighted that the impact of providing in-home care varies over the course of the patient’s illness. “When care needs can be anticipated and scheduled, and additional resources can be utilized to put a plan in place, the impact can be smaller. When care needs are unexpected or difficult to anticipate, the impact will be greater,” she says.
“Consider that your interrupted sleep several times a week in the middle of the night over a chronic period of time begins to have an impact on your own rest and even the ability to fall asleep with anticipated anxiety of what’s to come through the night,” Fields continues. As care needs become more demanding on working adults, often you’ll see a rise in absenteeism for scheduled and unscheduled medical needs, and a decrease in resiliency on behalf of the employee. Chronic fatigue, fear, stress and anxiety all compound and can have an impact on the health of the working adult.”
Unfortunately, these stories aren’t unique. For adults who are caring for a loved one and also continuing to work in their career, taking on these responsibilities can be stressful and lead to burnout, Field says. 60% of caregivers are also employed, and many feel the job-related stress piling up. But working from home does make a big difference, providing flexibility that in-home caregivers need.
Impact of Diabetes on Patients and Chronic Care
50% to 75% of people with diabetes have a caregiver involved in their healthcare (Fields et al., 2022). These caregivers are often partners, spouses, adult children, or siblings.
Like many chronic conditions, diabetes requires complex medical management that often requires following regimented eating plans, monitoring sugar levels, organizing daily medications, and coordinating medical care. The sicker George became, the more of these responsibilities fell on me.
Source: eClinicalWorks
The chronic care model is a multidimensional solution to the complex problem of providing care to patients with chronic health problems. The theory of this model says that a significant part of chronic care takes place outside of formal healthcare facilities (Katsarou et al., 2023).
It also states that six elements are central to initiatives to improve chronic care: community resources, healthcare system, patient self-management, decision support, service delivery system redesign, and clinical information systems. Interventions that include at least one of these elements are associated with improved outcomes for people with asthma, diabetes, heart failure, and depression. However, only patients with heart failure and depression had improved quality of life (Katsarou et al., 2023).
Flexible scheduling
Caregiving would have been impossible if I couldn’t work from home. George had 10 doctors, and that translated to roughly 3 days a week with at least one appointment. At that point, I had worked for my company for almost 20 years, which gave me unlimited sick time and lots of vacation time. I took my work laptop with me to doctor appointments, rearranged meetings, and still made time for my daughter’s activities.
Working from home gave me flexibility in managing caregiving tasks and professional responsibilities, including the ability to respond to his needs promptly, compared to me working in an office setting, or George being in a facility where staff are spread across multiple patients.
Another of Thomas’ readers, Jane, works remotely and looks after her father, who has Alzheimer’s. “Working from home has been a lifesaver,” she says. “I can attend to my dad’s needs throughout the day without compromising my work. It’s still challenging, but having that flexibility makes a huge difference.”
While working from home offers more flexibility to manage caregiving tasks, it can also blur the lines between work and caregiving responsibilities. “Many caregivers report feeling constantly “on-call,” which can lead to burnout, and that burnout affects over 33% of family caregivers who are working from home, compared to 20% who work in the office,” Shah reports.
Indeed, flexible work arrangements such as telecommuting, job-sharing, and flexible hours can help caregivers manage their time more effectively. However, since the pandemic ended, return-to-office mandates have flourished with employers who want to manage employees in person and/or fill their empty office spaces. 90% of companies plan to implement return-to-office policies by the end of 2024, according to a report from Resume Builder. Nearly 30% say their company will threaten to fire employees who don’t comply with in-office requirements.
Source: SuperStaff
But for employees who can work remotely, several caregiver pressures can be relieved. Removing the commute and a strict start or end time of an office job gives the remote employee flexibility. Fields gives some of examples:
“On mornings where there’s been a difficult night, an extra hour of sleep can make a world of difference on how the employee feels and functions that day. Being able to work from home may also make it possible to leverage telehealth appointments instead of having to physically travel to doctor’s appointments. Caregivers also have the ability to provide distant supervision and mealtime support for a loved one while working from home and don’t need to have as many outside resources coming into the home to provide that supervision or ensure meals are delivered and consumed. These small benefits relieve a lot of microstress.”
Caregiver Needs Analyzed with DECAF
A study at the University of West Attica in Greece investigated the needs of caregivers of patients suffering from CKD, stroke, cancer, dementia and multiple sclerosis (Katsarou et al., 2023). 89% of these caregivers were relatives, 50% were between 20 and 50 years old, and 19% were spouses. Researchers found themes among caregiver needs:
Caregiver training
Help with nursing home care and physical therapy
Help with financial burden from health services
Lack of reliable transport
Psychological support, including delivery via digital media and mobile devices
Social support groups
Navigating complex medical insurance
I agree with all of these points. To break it down a bit more, I’m using the DECAF framework (Fields et al., 2022), which was developed to raise awareness about caregiver responsibilities in care planning and execution during the hospital-to-home transition. Here’s how DECAF played out in my caregiving experience.
Direct Care Provision
Direct Care Provision refers to hands-on support with activities of daily living (ADLs) such as getting dressed, food preparation, toileting and physical activities, and taking the patient to healthcare appointments. It also includes nursing tasks like wound care and medication management. I was a certified nursing assistant in the 90s, and a home health aide in the 2000’s, both of which prepared me for my experience with George.
Emotional Support
Emotional Support is the empathy and compassion for the patient and caregiver.
I had no close friends nearby, and George’s family was local, but most of them were more hands-off. So as his condition took more and more of a toll on my mental health, I sought out family members, a therapist, and church groups for support and stress relief.
Social support can diminish the impact of the emotional burden and stress of care by providing solutions to problems, distractions from issues or facilitating the required healthy behaviors (Ibrahim et al., 2022). Caregivers who seek social support from family and friends experience a lesser burden of care than caregivers without solid support networks.
Seeking social support is the dominant coping mechanism for caregivers of patients undergoing renal replacement therapy (Ibrahim et al., 2022). Caregivers of chronic patients are four times more likely to be diagnosed with depression and three times more likely to seek help for anxiety issues than individuals who are not caregivers.
Being an in-home caregiver is lonely, and I lacked self-care. I’ve been working from home since 2005 so I was used to being alone, but caregiving for your spouse is a different kind of loneliness. I was losing my husband slowly as his condition got worse, and I needed social support. I mostly relied on my family (long-distance phone calls) and a local church group. In less than a year, I shifted from being a newlywed with an independent husband to a caregiver. My marital needs were not met, as George lost sexual function early on. This also caused strain on our relationship.
I’m not alone. A study on psychological health from Savitribai Phule Pune University in India confirms that dysfunctions caused by chronic illnesses aren’t limited to the patient, but affect the partner, and the couple’s dynamic, making a considerable impact on the satisfaction levels in the relationship (Umrigar and Mhaske, 2022). Behavioral and personality changes in the patient can overpower emotional bonds between the caregiver and the patient as well. The greater the negative effect, the greater the frequency of depression, anxiety, and somatization in the caregiver.
This study polled women caregivers about their male spouses with chronic conditions of cancer, coronary heart disease, and diabetes. They found clinically significant marital and sexual dissatisfaction. Since marital satisfaction and sexual satisfaction are closely linked, a decrease in one tends to have a serious impact on the other, and consequently, on the overall quality of life.
Care Coordination
Care Coordination involves initiating, managing and maintaining healthcare services and support. Managing diabetes successfully requires significant care organization and coordination of multiple types of interactions with the healthcare system. Participants in a study at the University of Wisconsin-Madison (Fields et al., 2022) frequently recognized caregiver roles in care organization, such as helping with tracking and scheduling appointments, taking notes before and during healthcare visits, and making lists of current medications.
I can concur. I took George to his appointments, acting as an administrative assistant and advocate. It was up to me to take notes, ask for what he needed, and verify or dispel inconsistent information (test results, guidance, data, etc.) between different doctors. I had a spreadsheet that the nurses loved, because it listed all the pertinent information about his medication names, amounts, prescribing doctor, reasons for taking them, etc.
Patient Advocacy
Advocacy is about empowering individuals to obtain resources. In the same Wisconsin study, several participants described experiences where the caregiver advocated on behalf of the patient when experiencing serious health complications linked to diabetes.
I was no different. As the months went on, George’s depression intensified into hopelessness and an “I don’t care anymore” attitude. So in addition to caregiving, I was also a fierce advocate for his mental health, trying to find resources to alleviate his chronic pain and help him feel more comfortable.
Financial Support
Financial support refers to help with planning and using financial resources. With rising home and institutional care costs and formal caregiver shortages, 66% of caregivers use their retirement and savings funds to pay for care (Genworth).
Source: Grants for Medical
Applying for Social Security disability payments was a huge challenge. One of the questions that caused a denial related to his unemployment status. He explained that his medications made him fall asleep intermittently and randomly, so he couldn’t work. They blamed his medication and denied his application two more times before he was finally approved. He then started receiving payments of about $700 per month.
George had no life insurance, and I didn’t receive any direct financial support until his last week of life. I wrote Facebook posts about his status while he was in hospice care, and many of my friends sent funds via PayPal and Cashapp to help me pay for the funeral.
Navigating Healthcare Systems and Insurance Complexities
Caregiving at home often leads to substantial financial strain due to the cost of medical supplies, home health aides, and necessary modifications to the home. Not to mention the daunting task of navigating health insurance complexities, from finding in-network healthcare providers, care coordination, and working with billing offices regarding Medicare and Medicaid.
Finding In-Network Medical Providers
Another huge barrier for caregivers and patients alike is finding healthcare providers within their insurance network—especially specialists like those George needed. According to a Kaiser Family Foundation study, 29% of people struggle to find new providers within their network. Providers change the insurers they participate with frequently, and the onus is on the caregiver or patient to figure out how much of their bill will be covered in any given scenario.
Source: New York Bone & Joint Specialists
I’ve had to seek therapy before I met George, not just during his illness. No matter what, it’s difficult to find an available, local provider. Once I found a therapist, we started off going to see her together, but eventually he stopped.
Thomas recommends using online directories, insurance company tools and telehealth services to find these providers. And Dr. McAllister mentions an advanced step I’d never heard of before: “If you can’t find an in-network provider for your loved one, you can obtain a single case agreement, where your company will recognize the out-of-network provider as if they were in-network.”
Decoding the Difference Between Primary and Secondary Payer Insurance
One recurring source of frustration for me was dealing with multiple billing departments about George’s insurance. The health insurance from my employer was primary, and Medicare was secondary. I made this clear for each medical provider (remember, he had 10 doctors). However, each billing department would call me to confirm multiple times based on how his claims were processed.
Source: Drive Safe Insure
The coordination of benefits between private insurance and Medicare/Medicaid is something Shawn Plummer, CEO of The Annuity Expert educates his customers about. For example, he explains that determining the primary and secondary payers can help maximize coverage and minimize out-of-pocket expenses. Additionally, exploring supplemental insurance options can fill gaps not covered by primary insurance plans.
Healthcare providers have their struggles working with health insurance companies as well. Take for example Dr. McAllister’s practice, which is in-network with Medicare and out-of-network with all private insurance companies.
“As a provider, it’s so difficult to deal with insurance, although Medicare is very straightforward and easy to work with if you abide by their rules,” she says. “If you understand that private insurance companies try to maximize profit by denying coverage, and go into the process knowing how to advocate, you won’t feel as frustrated.
Source:: Geeks for Geeks
“To add to the confusion, when people have Managed Medicare, the medicare rules apply but the private insurance manages Medicare. “I often suggest sticking to straight Medicare, not Managed Medicare, because standard Medicare tends to treat providers more fairly. Many providers won’t accept Managed Medicare because of the low reimbursement rates and bureaucracy associated with private insurance companies.”
Bert Hofhuis of Sovereign Boss in the UK says that many insurance plans, including Medicare and private insurance, have limitations on what they cover for in-home care. “For example, Medicare may cover some home health services but often does not cover custodial care.”
Dr. McAllister, Hofhuis, and Plummer shared more tips to navigate complex insurance issues:
Source: Investors
Understand the specifics of health insurance policies: Ask questions about things you don’t understand, and “seek plans that cover in-home care services, medical supplies, and home modifications to be prepared,” says Hofhuis. “It’s essential to review policy details and consider supplemental insurance to cover gaps.”
Take notes: “When dealing with insurance representatives on the phone, always write down the name of the person you speak with, information regarding the call and a reference for the call. Write everything down and email as much as possible so you have proof of everything,” Dr. Allister says.
Use HSAs and FSAs: When available, Plummer and Hofhuis recommend usingHSAs and Flexible Savings Accounts (FSAs), which can provide tax-advantaged funds that can be used for medical expenses, including caregiving costs.
Plan for long-term care: Consider purchasing long-term care insurance early to cover potential future caregiving needs.
Keep records for tax purposes: Keep detailed records of caregiving expenses, as some may be tax-deductible, potentially easing your financial burden, Plummer and Hofhuis concur.
Denise M. Brown, is Founder and CEO of The Caregiving Years Training Academy, a family caregiving agency that coordinates care across multiple systems. She shares that Medicare Part B reimburses for Caregiver Training, Community Health Integration Services and Principal Navigation Services. Family caregivers can receive these services on behalf of a Medicare beneficiary if that beneficiary cannot participate in care planning because of their illness.
“The interplay between private insurance and Medicare/Medicaid is a common source of confusion,” Shah says. “More educational resources are desperately needed to help caregivers understand these complexities, including decision trees to determine primary and secondary payers.”
Effective Care Coordination Between Health Systems
Getting Access to Supplies and Services
The healthcare system is disconnected and siloed. The complications that come with coordinating care getting medical supplies can be a hassle for caregivers. It requires time, energy, patience and diligence. I remember having to take note of each and every resource to get various supplies, whether it was for dialysis, a wheelchair, or even gauze strips.
According to AARP, nearly 75% of caregivers manage medications and medical tasks. Thomas’ reader Sarah went through a nightmare trying to get the right wheelchair for her husband. “We had to go through so much paperwork and phone calls with the insurance company,” she said.
Shah understands these frustrations. “Partnerships between tech and medical supply companies to streamline this process for caregivers would be super helpful,” he says.
Brown was also a caregiver, and shares her perspective as a provider: “We do our scheduling based on the provider’s schedule, which means working around our own work schedule. We may need to be with our patients when the nurse or home health aide comes. Because of staffing shortages, we often take the schedule that’s given even when the schedule completely derails our day.”
Improving Systems and Patient Satisfaction
Brown says that healthcare professionals can help caregivers and agencies alike by obtaining doctor orders and making effective referrals. “It’s frustrating to have to repeatedly call the doctor’s office to get an order for home health services and durable medical equipment,.” she says.
Source: Printablee
“It’s also important that the healthcare professionals know which providers have staff available. For instance, my dad received home health services with a visiting nurse. When I also asked for a home health aide, the nurse was upfront that there just wasn’t the staff available for home health aide to visit. We could work around that because my sister and I provided my dad’s personal care. Others may not have the luxury, so it’s important to know the reality of what we can expect.
Another thing to consider is the emotional effect on the patient when a provider or aide is no longer available.
For example, there was a week when neither Brown nor her sister would be available on a Friday to care for their dad. “I was waiting to hear if my dad’s home health provider could continue providing services for my dad. I waited to reconfigure my work day on Friday if I needed to provide care. I later heard back from the home health agency that benefits would continue. My dad was worried about benefits ending in part because he had formed a wonderful friendship with his nurse, and he loves her. But the system doesn’t take into account the emotional impact when services end. We miss the care, and we often also miss the care provider.”
Source: EDUCBA
Naama Stauber Breckler, Co-founder of Better Health, is trying to improve accessibility and convenience for people with chronic conditions and dependent on different medical devices and supplies. “Patients need the ability to easily discover and order medical supplies online and get an easy explanation of their insurance benefits, how to maximize them, and how to find the best products,” she says.
Dr. McAllister recommends contacting the insurance company to see what exactly is allowed (HHA, PT, OT, SLP and RN services). “Companies may try to give you less than your family needs, but your insurance company will help you understand what your rights are. Many home health companies are short-staffed, but if you know what you can get for your family member, you will be able to advocate for the best,” she says.
Addressing Caregiver Challenges with Care at Home
Some of the ways to address in-home caregiver challenges include care-at-home and Hospital-at Home programs, using RPM, employer-provided benefits and flexible work arrangements, and better health plan coverage.
The Rise of Hospital-at-Home Programs
Source: Rainbow Health
Care-at-home programs are integrated clinical programs created to deliver healthcare services that have either been traditionally provided within healthcare facilities or represent new care models for chronic disease management.
These programs typically combine remote insight into biometric data or symptoms via connected devices for remote patient monitoring (RPM) and communication with clinicians through telehealth modalities. Many care-at-home programs include in-home services such as durable medical equipment (DME), meal delivery, technical support, and therapeutics.
66% of hospitals and health systems currently offer patients a care-at-home service. Early care-at-home programs were primarily targeted at ad hoc or episodic care, often only relying on a telehealth visit. But the growing maturity of these models and the confidence of the clinical and operational leaders make it increasingly viable to treat chronically and acutely ill patients at home. The differences between these program types include the amount and type of RPM, the in-home services included, and the staffing required to operate the program.
Providing remote care at home can reduce the need for hospital admissions/early discharge, freeing up valuable hospital resources and beds and leaving patients and their families feeling supported in their own homes.
Remote Monitoring for Patients with Chronic Conditions
George’s endocrinologist recommended that he use a Dexcom device to track his blood sugar. This remote monitoring device was great for me because no matter where I was or what time it was, the Dexcom app sent my phone a notification whenever his sugar was too high or too low. It was especially helpful when I attended a conference 6 hours from home, but got his alerts throughout the day and night. His family stayed with him when I was gone, but I got the alerts.
“Remote monitoring technologies have been game-changers for caregivers managing chronic conditions,” Shah says. “… allowing caregivers and clinicians to monitor vital signs and symptoms remotely, providing peace of mind and enabling more proactive care.”
The Current Health platform helps hospitals and clinics provide healthcare services to patients in their homes. Patients can use this platform for various health conditions, including COVID-19, heart problems, pregnancy care, and cancer.
Survey respondents were confident that remote monitoring helps clinicians better understand the patient’s daily health.
Technology is essential to care-at-home programs, but the industry must embrace technology for these programs to be successful. According to another survey by Current Health and Sage Growth Partners, 51% of health system leaders cited patient engagement and adherence as a top challenge, with the most critical support service needs of clinical monitoring (54%), logistics (53%), and technical support (48%). In addition, interoperability between your care-at-home platform and the patient’s employee health record (EHR) is critical for reducing duplicative work for providers and ensuring you have a holistic view of the patient during and after their care-at-home experience.
RPM makes healthcare more accessible, as patients are monitored in their homes. Facing challenges such as high care costs, reduced revenue, and limited capacity, care at home is a cost-effective site of care that can provide better patient outcomes and satisfaction.
Employer Support
Employers can help by providing flexible work arrangements, paid leave, and Employee Assistance Programs (EAPs) that offer counseling, legal help, financial advice, and referrals to eldercare services.
Source: Academy to Innovate HR (AIHR)
In-home caregiving can significantly impact an employee’s ability to manage their work responsibilities. Logan Mallory, VP of Marketing at Motivosity offers flexible work arrangements, like reduced or flexible work hours, to help alleviate the stress of balancing caregiving and work duties. This flexibility allows employees to be present for their loved ones while still fulfilling their work commitments.
Motivosity also offers their employees unlimited paid time off (PTO), health savings accounts (HSAs), and comprehensive health insurance to support our caregiving employees, each of which benefits the employees who are also caregivers in specific ways:
Unlimited PTO ensures that employees can take the necessary time off without worrying about exhausting their leave.
HSAs help cover the costs of medical supplies and services, providing financial relief.
Health insurance plans that cover a wide range of services, including in-home care, which helps employees manage caregiving expenses more effectively. They also provide access to counseling services, stress management resources, mental health apps and gym access.
“While we can only do so much, employers should strive to provide as much support as possible to caregiving employees,” Mallory says. “By offering flexible solutions and understanding their unique challenges, we can help them manage their responsibilities more effectively.”
Health Plan Changes Needed
Insurance Coverage Gaps
Source: Jackson Insurance Brokers
In the U.S., patients and their caregivers could benefit from closing the following health insurance coverage gaps in their health plans:
Long-Term Services and Supports (LTSS): According to theHHS, 70% of people over 65 will require some type of LTSS, which is not covered under Medicare or most private health insurance plans.
Home and Community-Based Services (HCBS): There’s currently limited coverage for services that help with ADLs and care at home.
Caregiver Support Services: Lack of comprehensive coverage for services that directly support family caregivers, such as respite care, training, and counseling in some states.
Non-Expansion States: In states that have not expanded Medicaid, many low-income adults fall into a coverage gap, being ineligible for both Medicaid and Marketplace subsidies (Drake, et al., 2024).
10 Ways Health Plan Changes Can Support Caregivers
Source: Ramsey Solutions
Expand Medicaid Coverage: Adopting Medicaid expansion in all states could provide coverage to approximately 2.9 million uninsured adults, including many caregivers (Drake et al., 2024).
Integrate Caregiver Support: Incorporate caregiver support services into existing health care delivery models and value-based care programs.
Enhance LTSS and HCBS Coverage: Expand coverage for these services under Medicare, Medicaid, and private insurance plans to reduce out-of-pocket costs for families.
Improve Remote Care Options: Expand coverage and availability of remote patient monitoring and telehealth services to support both patients and caregivers. Hospital-at-Home programs should be a mainstay in health plan coverage. These programs are customer-centric, result in lower hospital readmission rates, increase hospital capacity, and reduce issues with resource allocation among clinical staff.
Develop Caregiver-Specific Insurance Products: Create insurance plans or supplemental coverage options designed to meet the unique needs of caregivers.
Enhance Workplace Policies: Encourage employers to offer flexible work arrangements and maintain health insurance coverage for employees who are caregivers (Tingey et al., 2020).
Improve Caregiver Identification and Assessment: Implement systematic processes in healthcare settings to identify, assess, and support caregivers.
9. Include Caregiver Metrics in Quality Measures: Incorporate caregiver experiences and outcomes into healthcare quality measurements to incentivize better support.
Prepare Healthcare Professionals: Enhance training for healthcare providers on person- and family-centered care to better support caregivers. Psychoeducational information (e.g., treatment, lifestyle, etc.) and healthcare (e.g., emotional support, practical services, etc.) were the most common unmet need domains across health conditions (Thomas et al, 2023). Addressing unmet informational or healthcare needs may help optimize outcomes and care for children and families living with common chronic health conditions.
By addressing these gaps and implementing these improvements, the U.S. healthcare system could significantly enhance support for both caregivers and patients by reducing the financial and emotional burden on families while improving overall care outcomes.
Supporting Caregivers and Their Families
Source: Caryfi
As we’ve explored throughout this article, home care programs and RPM offer transformative benefits for both patients and caregivers. These solutions provide enhanced flexibility, improved care coordination, crucial support for managing chronic conditions and reducing caregiver burden. Expanding health plan coverage for these programs is not just beneficial, but necessary.
Hospital-at-Home (HaH) programs, in particular, represent a cost-effective, patient-centered approach that deserves widespread adoption. Every health institution could likely benefit from such a program to increase the capacity of their facility, enhance customer-centricity and patient satisfaction, and promote better patient outcomes. It’s the way of the future, and the way patients want to receive care. So we call on healthcare providers and health plans to prioritize the inclusion of care-at-home programs in their coverage.
By supporting caregivers and improving patient outcomes, we can create a more efficient, compassionate healthcare system. This requires a collaborative effort from healthcare providers, insurers, policymakers, and technology innovators to truly enhance the caregiving experience and, ultimately, the quality of life for both patients and their dedicated caregivers.
References
Carter, K., Blakely, C., Zuk, J., Brittan, M., & Foster,C. Employing Family Caregivers: An Innovative Health Care Model. Pediatrics. 2022; 149(6), 1-4. doi.org/10.1542/peds.2021-054273
“Compensation For Caregiving.” Colorado Respite Coalition, https://coloradorespitecoalition.org/family-caregivers/compensation-for-caregiving.php. Accessed 2 July 2024.
Costa, S., Ferreira, J., Leite, Â., & Pereira, M. G. (2021). Traumatic stress as a mediator of quality of life and burden in informal caregivers of amputees due to diabetic foot: a longitudinal study. Health Psychology Report, 9(4), 339, 345. https://doi.org/10.5114/hpr.2020.101495
Drake, P., Tolbert, J., Rudowitz, R, & Damico, A. “How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion?” KFF, 26 Feb. 2024, https://www.kff.org/medicaid/issue-brief/how-many-uninsured-are-in-the-coverage-gap-and-how-many-could-be-eligible-if-all-states-adopted-the-medicaid-expansion. Accessed 2 July 2024.
Fakeye, M.B.K., Samuel, L.J., Drabo, E.F., Bandeen-Roche, K., & Wolff, J.L. Caregiving-Related Work Productivity Loss Among Employed Family and Other Unpaid Caregivers of Older Adults. Value in Health. 2023;26(5):712. https://doi.org/10.1016/j.jval.2022.06.014
Favreault, M., Dey, J., Anderson, L., Lamont, H., & Marton, W. “Future Change in Caregiving Networks: How Family Caregivers and Direct Care Workers Support Older Adults Now and in the Future.” Assistant Secretary for Planning and Evaluation, 2 Aug, 2023, https://aspe.hhs.gov/sites/default/files/documents/a449863a8c93838d37f78ccf29e9231f/future-change-caregiving-networks.pdf. Accessed 2 July 2024.
Fields B., Makaroun L., Rodriguez K.L., Robinson C., Forman J., & Rosland A-M. Caregiver role development in chronic disease: A qualitative study of informal caregiving for veterans with diabetes. Chronic Illness. 2022;18(1):193, 196. doi:10.1177/1742395320949633
“How Caregiving Impacts Families, Communities and Society.” Genworth, 27 Oct. 2021, https://pro.genworth.com/riiproweb/productinfo/pdf/682801BRO.pdf. Accessed 2 July 2024.
Ibrahim N., Chu S., Siau C., Amit N., Ismail R., Halim A., & Gafor, A. The effects of psychosocial and economic factors on the quality of life of patients with end-stage renal disease and their caregivers in Klang Valley, Malaysia: protocol for a mixed-methods study. BMJ Open. 2022;12(6):1-2. doi:10.1136/bmjopen-2021-059305
Katsarou, A., Intas, G., & Pierrakos, G. Investigating the Needs of Caregivers of Patients Suffering from Chronic Diseases: A Mixed-Method Study. Indian Journal of Palliative Care. 2023; 29(3), 285-286. https://doi.org/10.25259/IJPC_179_2022
Khurana, Sanjay. “Caregiver Support | Gaps, Opportunities and Emerging Models in Healthcare.” Linkedin, 19 Oct. 2023, https://www.linkedin.com/pulse/caregiver-support-gaps-opportunities-emerging-models-sanjay-khurana. Accessed 2 July 2024.
Smith, Morgan. “90% of companies say they’ll return to the office by the end of 2024—but the 5-day commute is ‘dead,’ experts say.” CNBC, 11 Sept. 2023, https://www.cnbc.com/2023/09/11/90percent-of-companies-say-theyll-return-to-the-office-by-the-end-of-2024.html. Accessed 26 June 2024.
Thomas S., Ryan N.P., Byrne L.K., Hendrieckx C., White V. Unmet supportive care needs of families of children with chronic illness: A systematic review. Journal of Clinical Nursing. 2023; 32(19-20): 7101. https://doi.org/10.1111/jocn.16806
Tingey, J.L., Lum, J. Morean, W., Franklin, R., & Bentley, J.A. Healthcare Coverage and Utilization Among Caregivers in the United States: Findings From the 2015 Behavioral Risk Factor Surveillance System. Rehabilitation Psychology. 2020; 65(1), 63-71. http://dx.doi.org/10.1037/rep0000307
Umrigar D, Mhaske R. Psychological Health of Wives’ of Patients with Chronic Illnesses. Journal of Psychological Research. 2022;4(1):1-2. doi:10.30564/jpr.v4i1.3879
