By Mary Myers

Traditional hospitals today account for about a third of all medical spending—an incredible $1.1 trillion. However, during this era of consolidation across health care, we are seeing a steep decline in inpatient facilities. In fact, 20 percent fewer hospitals are operating in the United States than 35 years ago, and they are treating the lowest number of patients since 1946, despite a 40 percent increase in population.

I see this downward trend as a good thing.

Innovations in technology and improved care services are reducing both patient stays and, ultimately, the need for additional hospital beds. Fifty years ago, patients recuperated in the hospital for weeks after an appendectomy. Today, they go home the same or next day. With the help of enhanced medical techniques and technology, we can transition patients out of hospitals sooner, which can help save costs and help with their recovery.

Telemedicine and remote monitoring continue to advance, saving time and money by enabling patients to talk to their providers by remote video and allowing for check-ins between office visits. We continue to develop biosensors and health apps to help physicians and care teams monitor patients at home, reading their blood pressure, glucose levels and heart rates in real time and initiating treatment before a condition becomes a real problem.

The shift away from traditional inpatient facilities also means consumers are turning elsewhere to receive safe, effective care—and often at lower costs. For example, hip and knee replacements used to mean days in the hospital; patients now may stay as little as one night in an ambulatory surgical center.

These trends lead me to predict that within the next 20 years, we will be providing the vast majority of health care services in home and community settings—where the majority of people prefer to receive care. Every day there are 10,000 more adults eligible for Medicare, and research shows that about 90 percent of seniors say they intend to continue living in their homes as long as possible.

We will still need full-service hospitals to serve an important role in the care continuum. However, in the future, they’ll focus on what they do best: managing complex illnesses, intensive care and high-level urgent conditions. We will also need their expertise, more than ever, to understand how we can deliver care in different settings, such as in the home.

Instead of a hospital-centric model, we want to focus on home and community care and use other settings as needed. All key parts of the health care system can work together to keep patients at home and living well in their community.

As health systems struggle under extreme pressures, it’s worth it to disrupt the norm and start an evolution in care. We can transform the system as a whole by providing alternative care settings that can achieve better outcomes, lower total costs, and help our patients be healthier and happier.

As president/CEO and chief quality officer of Johns Hopkins Home Care Group, Inc. (JHHCG), Mary Myers focuses on providing the highest quality care to patients within their homes and the community. Myers began her tenure with Johns Hopkins Medicine in 1981, and later went on to manage Johns Hopkins Bayview’s CICU, PCU and MICU. She then created and implemented Bayview's comprehensive care management program and worked with the JHU Case Management Academy to implement programs nationwide. Myers began working with operations integration, which led her to JHHCG, where she created and implemented a robust quality and safety program. In 2005, she became VP/chief operating officer before assuming her current role in 2016.

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